Most Relevant Information
Provider Data
| NPI Number: | 1003573593 |
| Provider Name: | JANIE MARIE LEATHERS |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/19/2021 |
| Last Updated: | 11/19/2021 |
Provider Practice Location
2439 COUNTY ROAD 1610
CAIRO
MO
652392345
Practice Location Phone/Fax
| Phone: | 6606519107 |
| Fax: |
Provider Mailing Location
2439 COUNTY ROAD 1610
CAIRO
MO
652392345
Provider Mailing Phone/Fax
| Phone: | 6606519107 |
| Fax: |