Healthcare Provider Details

I. General information

NPI: 1962313387
Provider Name (Legal Business Name): LEAH HARRIS MS, ATC, CES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 SOUTH RD
CHAPEL HILL NC
27514-4232
US

IV. Provider business mailing address

96 WOODLAND GROVE LN
CHAPEL HILL NC
27516-4166
US

V. Phone/Fax

Practice location:
  • Phone: 302-584-6037
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number1172
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: