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General NPI Number Information
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NPI Number | 1679408017
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Entity Type | Individual
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Provider Name | JOSHUA CAMERON LEIDICH
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Gender | Male
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Dates
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Enumeration Date | 06/16/2026
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Last Update Date | 06/16/2026
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Provider Practice Location Address
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Address Line | 101 N COLLEGE AVE
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City | ANNVILLE
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State | PA
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Zip | 17003-1400
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Country | US
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Telephone | 717-867-6161
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Fax |
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Provider Business Mailing Address
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Address Line | 337 MIDWAY RD
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City | MOUNT JOY
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State | PA
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Zip | 17552-3203
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Country | US
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Telephone | 717-719-1771
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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