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General NPI Number Information
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NPI Number | 1629365150
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Entity Type | Individual
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Provider Name | LESLIE M. MEAD DPT
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Gender | Female
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Dates
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Enumeration Date | 07/05/2011
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 455 CHESTNUT ST
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City | MEADVILLE
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State | PA
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Zip | 16335-4404
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Country | US
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Telephone | 814-547-5610
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Fax |
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Provider Business Mailing Address
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Address Line | 15673 MAILLARD RD
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City | GUYS MILLS
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State | PA
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Zip | 16327-2047
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Country | US
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Telephone | 814-573-3665
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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 | PT021460
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License Number State | PA
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