Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant |
NPI | 1013501089 |
---|---|
Provider Name | Marcus Leigh |
First Address | Round Rock, TX 78664-4046 |
Second Address | Glenview, IL 60026-8001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2021 |
Last Update Date | 21/02/2021 |