Brian Tyler Leach

NPI #1003373564 in Saint Louis, Missouri

Provider Information

NPI Number: 1003373564
Entity Type: Individual
Name: Brian Tyler Leach
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Feb 20, 2019
Last Updated: Feb 20, 2019

Practice Location

Address: 6120 WANDA AVE
City: Saint Louis
State: Missouri
ZIP Code: 63116-2225
Phone: (636) 234-4277

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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