Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Derrick Andre Leach

Individual provider Massage Therapist · NPI 1568079911

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 Pt
Ellenwood, GA 30294-6697
Phone: (404) 396-3850
Show map & directions

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 number1568079911
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 29, 2020
Last updated in NPPESSeptember 29, 2020
Certification dateSeptember 29, 2020
Mailing address5685 Washakie Pt, Ellenwood, GA 30294-6697

Other providers in Ellenwood