Healthcare Provider Details

I. General information

NPI: 1215221023
Provider Name (Legal Business Name): LUCAS LEPPLA PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 S TRIMBLE RD
MANSFIELD OH
44906-3427
US

IV. Provider business mailing address

1025 S TRIMBLE RD
MANSFIELD OH
44906-3427
US

V. Phone/Fax

Practice location:
  • Phone: 419-529-4602
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT. 013219
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: