Richard Leathery II, ATC

Individual provider Active NPI Athletic Trainer · Dover, PA

NPI 1083837124 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1083837124
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
RT001447A (PA)
Practice address
46 W Canal St
Dover, PA 17315-1404
Phone
(717) 292-3671
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RT001447APAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT001447A PA Yes

Addresses

Primary practice location

46 W Canal St
Dover, PA 17315-1404

Mailing address

126 Timber LN
Hanover, PA 17331-9210

Other providers in Dover, PA

All providers in Dover, PA · Athletic Trainer in Pennsylvania

Sources for this page

Verify at the official NPI Registry.