Individual ProviderMadison B LeatherwoodBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address6100 Veterans Pkwy Ste 11, Columbus, GA 31909-3514(813) 438-6796PECOS EnrollmentBased on the most recent information from CMS, provider Madison B Leatherwood does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1104673847Provider TypeIndividualFull NameLeatherwood, Madison BGenderFemaleSole ProprietorNoEnumeration Date5/1/2024Last Updated5/1/2024Contact InformationPractice LocationPractice Address6100 Veterans Pkwy Ste 11, Columbus, GA 31909-3514Phone(813) 438-6796Fax(813) 252-1367Mailing LocationMailing Address1202 Tech Blvd Ste 104, Tampa, FL 33619-7863PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerGeorgia