| Mr Derrick Andre Leach, | |
|
5685 Washakie Pt, Ellenwood, GA 30294-6697 | |
| (404) 396-3850 | |
| Not Available |
| Full Name | Mr Derrick Andre Leach |
|---|---|
| Gender | Male |
| Speciality | Massage Therapist |
| Location | 5685 Washakie Pt, Ellenwood, Georgia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568079911 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225700000X | Massage Therapist | MT008448 (Georgia) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Derrick Andre Leach, 5685 Washakie Pt, Ellenwood, GA 30294-6697 Ph: (404) 396-3850 | Mr Derrick Andre Leach, 5685 Washakie Pt, Ellenwood, GA 30294-6697 Ph: (404) 396-3850 |
Vonda S Hendrickson, LMT Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 15 Belmont Farms Dr, Ellenwood, GA 30294 Phone: 404-492-2248 Fax: 770-507-6644 | |
Christal Love, LMT Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 5240 Katherine Village Dr, Ellenwood, GA 30294 Phone: 770-282-7081 | |
Ms. Qiana L Gordon, LMT Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 4376 Northwind Dr, Ellenwood, GA 30294 Phone: 678-886-2203 |