Healthcare Provider Details

I. General information

NPI: 1285006312
Provider Name (Legal Business Name): LEAH ELISE LAGASSE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEAH ELISE MCMILLION DPT

II. Dates (important events)

Enumeration Date: 10/28/2015
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9251 STONESTREET RD
LOUISVILLE KY
40272-2858
US

IV. Provider business mailing address

501 FOREST LANE SUITE A
CLEMSON SC
29631
US

V. Phone/Fax

Practice location:
  • Phone: 877-407-3422
  • Fax: 877-407-4329
Mailing address:
  • Phone: 864-654-2001
  • Fax: 800-305-7112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT4089
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9232
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: