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General NPI Number Information
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NPI Number | 1063736445
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Entity Type | Individual
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Provider Name | LEANDRA HUFFMAN LMT,CMT
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Gender | Female
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Dates
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Enumeration Date | 03/15/2010
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Last Update Date | 07/15/2022
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Provider Practice Location Address
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Address Line | 3406 BRAMBLETON AVE
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City | ROANOKE
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State | VA
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Zip | 24018-6520
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Country | US
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Telephone | 304-952-1935
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Fax |
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Provider Business Mailing Address
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Address Line | 4836 WARRIOR DR
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City | SALEM
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State | VA
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Zip | 24153-5816
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Country | US
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Telephone | 304-952-1935
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 2009-2618
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 0019008505
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License Number State | VA
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