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General NPI Number Information
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NPI Number | 1477153674
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Entity Type | Organization
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Legal Business Name | LEAP PEDIATRIC PHYSICAL THERAPY INC.
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 10/27/2020
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Provider Practice Location Address
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Address Line | 2660 OSWELL ST STE 121
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City | BAKERSFIELD
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State | CA
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Zip | 93306-3154
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Country | US
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Telephone | 661-335-7755
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Fax | 661-335-7766
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Provider Business Mailing Address
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Address Line | PO BOX 2029
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City | BAKERSFIELD
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State | CA
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Zip | 93303-2029
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Country | US
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Telephone | 661-335-7755
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Fax |
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Authorized Official
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Title or Position | MANAGER/CREDENTIALING
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Name | SANDY REED
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Credential |
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Telephone | 661-335-7755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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