Healthcare Provider Details

I. General information

NPI: 1083539464
Provider Name (Legal Business Name): EMILEE LEITING PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 W 6TH ST STE 101
SPENCER IA
51301-3906
US

IV. Provider business mailing address

PO BOX 627
ARNOLDS PARK IA
51331-0627
US

V. Phone/Fax

Practice location:
  • Phone: 712-580-5008
  • Fax: 712-250-2415
Mailing address:
  • Phone: 712-580-5008
  • Fax: 712-250-2415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number139818
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: