Healthcare Provider Details

I. General information

NPI: 1740351766
Provider Name (Legal Business Name): LEAH R GASS P.T., M.S.P.T
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 E HIGHLAND AVE SUITE 310
PHOENIX AZ
85016-4872
US

IV. Provider business mailing address

4111 N DRINKWATER BLVD APT G105
SCOTTSDALE AZ
85251-3647
US

V. Phone/Fax

Practice location:
  • Phone: 602-955-8885
  • Fax: 602-955-8895
Mailing address:
  • Phone: 914-645-6342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number7041
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: