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TAMARA ELIZABETH LEISEY OTR/L

>> Massage Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1932408135

Individual Registrant:
 TAMARA ELIZABETH LEISEY OTR/L
Gender: F
Not Sole Proprietor

Location and contact information for practice:
22 SW 258TH ST  NEWBERRY, FL 32669-4133 US
Tel: 352-474-6111  Fax: 352-474-6112

Contact information for business:
PO BOX 700  CHIEFLAND, FL 32644-0700 US
Tel: 352-490-7500  Fax: 352-490-7110

Registration Information:
NPI: 1932408135
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N225700000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Massage Therapist
FLMA26936
Y225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Occupational Therapist
FLOT14482

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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