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General NPI Number Information
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NPI Number | 1811233224
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Entity Type | Individual
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Provider Name | JACQUELYN LEONARD MS, ATC, CES, CSCS
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Gender | Female
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Dates
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Enumeration Date | 12/13/2012
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Last Update Date | 10/10/2014
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Provider Practice Location Address
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Address Line | 1024 TOPPIN BLVD
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City | HARRISONBURG
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State | VA
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Zip | 22801-1631
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Country | US
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Telephone | 540-578-3811
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Fax |
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Provider Business Mailing Address
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Address Line | 261 BLUESTONE DR MSC 2301, GODWIN 128
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City | HARRISONBURG
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State | VA
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Zip | 22807-1009
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Country | US
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Telephone | 540-568-2973
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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 | 0126001051
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License Number State | VA
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