Healthcare Provider Details

I. General information

NPI: 1124834296
Provider Name (Legal Business Name): LEAH FRIEDENBERG DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3556 TOM AUSTIN HWY STE 2
SPRINGFIELD TN
37172-3960
US

IV. Provider business mailing address

37 WHITNEY FARM PL
MORRISTOWN NJ
07960-5988
US

V. Phone/Fax

Practice location:
  • Phone: 615-492-4595
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP052012T
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02308000
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP056401T
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP049270T
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: