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General NPI Number Information
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NPI Number | 1376855890
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Entity Type | Individual
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Provider Name | CHERYL MARIE LEEMHUIS PTA
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Gender | Female
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Dates
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Enumeration Date | 07/13/2010
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Last Update Date | 07/13/2010
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Provider Practice Location Address
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Address Line | 2485 S MAJOR DR
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City | BEAUMONT
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State | TX
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Zip | 77707-5019
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Country | US
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Telephone | 409-866-1003
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Fax | 409-866-1006
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Provider Business Mailing Address
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Address Line | 5730 JACKIE LN
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City | BEAUMONT
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State | TX
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Zip | 77713-9260
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Country | US
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Telephone | 409-673-6399
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2031789
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License Number State | TX
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