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NPI Code Detail

MEDICARE: LESLIE LINCK WHITE P.T.

MEDICARE: LESLIE LINCK WHITE P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT22844CA

General Provider Information

NPI Number : 1558457226
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE LINCK WHITE P.T.
Provider Business Mailing Address
First Line : 1779 WOODSIDE RD
Second Line : SUITE #102
City : REDWOOD CITY
State : CA
Zip : 94061-3461
Country : US
Telephone Number : 650-780-9700
Fax Number :
Provider Business Practice Location Address
First Line : 1779 WOODSIDE RD
Second Line : SUITE #102
City : REDWOOD CITY
State : CA
Zip : 94061-3461
Country : US
Telephone Number : 650-780-9700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 10/24/2007

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Directions to “ LESLIE LINCK WHITE P.T.” Practice Location

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