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1780913509
JENNIFER A LEACH
PEORIA, IL
NPI
1780913509
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: IL 160002608)
Enumeration Date
2009-12-08
Last Update Date
2009-12-08
Business Address
-- JENNIFER A LEACH PTA
5409 N KNOXVILLE AVE STE 400
PEORIA, IL 61614
Phone number: 309-692-6644
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Mailing Address
-- JENNIFER A LEACH PTA
5401 N KNOXVILLE STE 400
PEORIA, IL 61614-5021
Phone number: 309-692-6644
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