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General NPI Number Information
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NPI Number | 1205225422
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Entity Type | Individual
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Provider Name | TONYA LEONARD
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Gender | Female
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Dates
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Enumeration Date | 01/12/2015
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Last Update Date | 01/12/2015
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Provider Practice Location Address
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Address Line | 1006 GREEN RD 1006 GREEN RD.
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City | CHATSWORTH
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State | GA
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Zip | 30705-2012
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Country | US
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Telephone | 706-271-6282
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Fax | 706-517-1385
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Provider Business Mailing Address
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Address Line | PO BOX 871 P.O. BOX 871
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City | CHATSWORTH
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State | GA
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Zip | 30705-0871
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Country | US
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Telephone | 706-271-6282
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Fax | 706-517-1385
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 004205
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License Number State | GA
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