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General NPI Number Information
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NPI Number | 1265001887
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Entity Type | Individual
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Provider Name | MS. ERIN LEACH
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Gender | Female
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Dates
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Enumeration Date | 06/18/2021
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Last Update Date | 06/18/2021
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Provider Practice Location Address
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Address Line | 2040 W MAIN ST STE 312
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City | RAPID CITY
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State | SD
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Zip | 57702-2447
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Country | US
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Telephone | 605-941-7174
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Fax | 605-231-4312
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Provider Business Mailing Address
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Address Line | 629 S MINNESOTA AVE STE 104
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City | SIOUX FALLS
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State | SD
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Zip | 57104-4875
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Country | US
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Telephone | 605-941-7174
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT11156
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License Number State | SD
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