Provider Demographics
NPI:1821582974
Name:LEARY, LEONARD LYNN
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:LYNN
Last Name:LEARY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6033 TYLER POINT DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-2177
Mailing Address - Country:US
Mailing Address - Phone:513-284-9777
Mailing Address - Fax:
Practice Address - Street 1:6 S 2ND ST STE 824
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-2869
Practice Address - Country:US
Practice Address - Phone:513-737-1782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker