Provider Demographics
NPI:1154716058
Name:LEONARD, WILLIAM (ATC)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:LEONARD
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 LA MAISON DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2506
Mailing Address - Country:US
Mailing Address - Phone:408-396-8069
Mailing Address - Fax:
Practice Address - Street 1:615 LA MAISON DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2506
Practice Address - Country:US
Practice Address - Phone:408-396-8069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer