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General NPI Number Information
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NPI Number | 1225379043
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Entity Type | Organization
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Legal Business Name | LA SPEECH THERAPY PC
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Dates
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Enumeration Date | 03/04/2013
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Last Update Date | 03/04/2013
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Provider Practice Location Address
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Address Line | 207 W 2ND ST SUITE 4
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City | OTTUMWA
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State | IA
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Zip | 52501-2541
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Country | US
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Telephone | 641-814-1141
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Fax | 866-611-9554
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Provider Business Mailing Address
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Address Line | 207 W 2ND ST SUITE 4
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City | OTTUMWA
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State | IA
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Zip | 52501-2541
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Country | US
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Telephone | 641-814-1141
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Fax | 866-611-9554
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MRS. LEIGHANNE PAIGE
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Credential | MS.-CCC-SLP
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Telephone | 641-814-1141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | 002314
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License Number State | IA
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