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EDA LEACH

Exclusive Provider Organization

NPI: 1619294634Organization

Specialties, Licenses & Credentials

Social Worker

Social Worker

Code: 104100000X

638107811(MI)
Point of Service

Point of Service

Code: 305S00000X

638107811(MI)
Exclusive Provider OrganizationPrimary

Exclusive Provider Organization

Code: 302F00000X

638107811(MI)

Contact & Hours

Address
1746 DEN HERTOG ST SW
WYOMING, MI 49519

Quick Facts

NPI
1619294634
Entity Type
Organization
Medicare
Not confirmed
Specialties
3
Locations
1

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