1. Home
  2. Directory
  3. Georgia
  4. Ellenwood
  5. Massage Therapist
  6. NPI Profile

MR. DERRICK ANDRE LEACH
NPI 1568079911
Massage Therapist in Ellenwood, GA

Active since September 29, 2020
5685 WASHAKIE PT, ELLENWOOD, GA 30294(404) 396-3850 Get Directions Write a Review

NPPES record last updated: September 29, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Derrick Andre Leach NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. DERRICK ANDRE LEACH (NPI 1568079911) is an individual massage therapist in Ellenwood, Georgia, licensed in Georgia (MT008448) and active in the NPI registry since September 2020.

NPPES Registry Identity

NPI1568079911
Entity TypeIndividualMale
Primary Taxonomy225700000X
Provider Legal NameMR. DERRICK ANDRE LEACH
Location Address5685 WASHAKIE PTEllenwood, GA 30294-6697
Mailing Address5685 Washakie PtEllenwood, GA 30294-6697 · (404) 396-3850
Phone(404) 396-3850
Sole ProprietorNo
Enumeration DateSeptember 29, 2020
NPPES CertifiedSeptember 29, 2020
✔ NPI 1568079911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in GA · MT008448
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
5685 WASHAKIE PT, Ellenwood, GA 30294
Open in Google Maps ↗

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derrick Leach's NPI number?

The NPI number for Derrick Leach is 1568079911. It was assigned to this individual provider in the NPPES registry on September 29, 2020.

Where is Derrick Leach located?

Derrick Leach practices at 5685 Washakie Pt, Ellenwood, GA 30294. The listed phone number is (404) 396-3850.

What is Derrick Leach's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Derrick Leach was last updated on September 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.