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NPI Code Detail

MEDICARE: JOSHUA CAMERON LEIDICH

MEDICARE: JOSHUA CAMERON LEIDICH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1679408017
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA CAMERON LEIDICH
Provider Business Mailing Address
First Line : 337 MIDWAY RD
Second Line :
City : MOUNT JOY
State : PA
Zip : 17552-3203
Country : US
Telephone Number : 717-719-1771
Fax Number :
Provider Business Practice Location Address
First Line : 101 N COLLEGE AVE
Second Line :
City : ANNVILLE
State : PA
Zip : 17003-1400
Country : US
Telephone Number : 717-867-6161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2026
Last Update Date : 06/16/2026

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Directions to “ JOSHUA CAMERON LEIDICH ” Practice Location

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