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General NPI Number Information
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NPI Number | 1154929024
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Entity Type | Individual
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Provider Name | SHELBY LEGGETT PT, DPT, COMT
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Gender | Female
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Dates
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Enumeration Date | 10/13/2020
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 2340 HEMBY LN STE 200
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City | GREENVILLE
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State | NC
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Zip | 27834-3792
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Country | US
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Telephone | 252-758-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 2019B LEIGHTON DR
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City | GREENVILLE
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State | NC
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Zip | 27834-4854
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Country | US
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Telephone | 919-440-9738
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P19694
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License Number State | NC
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