Healthcare Provider Details

I. General information

NPI: 1679297683
Provider Name (Legal Business Name): LEIGH ANNE POLLARD OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2022
Last Update Date: 10/03/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 GOSSMAN RD
SOUTHERN PINES NC
28387-2225
US

IV. Provider business mailing address

523 LILY PAD LN APT 523
SANFORD NC
27332-5409
US

V. Phone/Fax

Practice location:
  • Phone: 910-246-1000
  • Fax:
Mailing address:
  • Phone: 919-812-4963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: