| Doctor Name: | JOY EARLENE LEEDHAM |
| NPI Number: | 1093974198 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | OPTICIAN |
| License Number: | A155 |
| Business Practice Address: | 11723 Old Glenn Hwy Suite 201 Eagle River, AK - 995777733 |
| Business Phone Number: | 9076884979 |
| Business Fax Number: | |
| Mailing Address: | 17668 Werre St, CHUGIAK |
| State: | AK |
| Postal Code: | 995676761 |
| Phone Number: | 9076884979 |
| Fax Number: | |
| NPI Enumeration Date: | 06/03/2008 |
| NPI Last Update Date: | 12/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FC0800X |
| License Number: | A155 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AK |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Contact Lens |
| Taxonomy Definition: | An optician or other ancillary support staff person who, where authorized by state law and trained or certified to do so, may fit or dispense contact lenses to a patient based on the prescription of an optometrist or medical physician. |