Mr. Derrick Andre Leach
Mr. Derrick Andre Leach is a Massage Therapist in Ellenwood, Georgia. Licensed in Georgia. Registered with an NPI since 2020.
- Licensed in
- GA
- In the registry since
- 2020
Practice location Address checks out
5685 Washakie PtEllenwood, GA 30294-6697
Phone: (404) 396-3850
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Massage Therapist (primary) | Taxonomy 225700000X · Licence MT008448 (GA) |
|---|
Record details
| NPI number | 1568079911 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | September 29, 2020 |
| Last updated in NPPES | September 29, 2020 |
| Certification date | September 29, 2020 |
| Mailing address | 5685 Washakie Pt, Ellenwood, GA 30294-6697 |
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MS. Qiana L Gordon, LMT
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-
Vonda S Hendrickson, LMT
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