Healthcare Provider Details

I. General information

NPI: 1376838193
Provider Name (Legal Business Name): JAMIE LYNN LEUGERS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 06/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 S STATE ST
FRANKLIN IN
46131-2552
US

IV. Provider business mailing address

1800 N WABASH RD STE 300
MARION IN
46952-1300
US

V. Phone/Fax

Practice location:
  • Phone: 317-736-6414
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05009645A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: