| NPI | 1972250009 |
|---|---|
| Former Legal Business Name | LEATHERMAN HEALTHCARE, LLC |
| Entity Type | Organization |
| Authorized Contact | GWENN LEATHERMAN CEO 301-418-5828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2022-03-08 |
| Last Update Date | 2022-11-23 |