Individual provider · Type 1 NPI
Derrick Andre Leach
Massage Therapist · Ellenwood, GA
NPI number
1568079911
Active
Practice location
5685 Washakie Pt
Ellenwood, GA 30294-6697
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist Primary | 225700000X | MT008448 (GA) |
Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
Other massage therapist providers in Ellenwood
About NPI 1568079911
Derrick Andre Leach's National Provider Identifier is 1568079911, issued on Sep 29, 2020. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Ellenwood, GA. The record was last updated on Sep 29, 2020.