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NPI Code Detail

MEDICARE: NAOMI LEACH

MEDICARE: NAOMI LEACH
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1750829503
Entity Type Code : Individual
Provider Name (Legal Business Name) : NAOMI LEACH
Provider Business Mailing Address
First Line : 433 S LARMON
Second Line : 433 S LARMAN
City : COLCORD
State : OK
Zip : 74338-5034
Country : US
Telephone Number : 918-326-4116
Fax Number :
Provider Business Practice Location Address
First Line : 433 S LARMON
Second Line : 433 S LARMAN
City : COLCORD
State : OK
Zip : 74338-5034
Country : US
Telephone Number : 918-326-4116
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2017
Last Update Date : 02/01/2017

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Directions to “ NAOMI LEACH ” Practice Location

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