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General NPI Number Information
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NPI Number | 1912083312
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Entity Type | Individual
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Provider Name | LESLIE CHESSON WOLFF PT
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Gender | Female
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 03/14/2021
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Provider Practice Location Address
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Address Line | 5 DUNDAS CIR STE B
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City | GREENSBORO
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State | NC
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Zip | 27407-1638
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Country | US
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Telephone | 336-294-3338
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Fax | 336-294-6696
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Provider Business Mailing Address
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Address Line | 7402 CORNUS CT
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City | SUMMERFIELD
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State | NC
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Zip | 27358-9514
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Country | US
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Telephone | 336-294-3338
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Fax | 336-294-6696
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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 | 2044
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License Number State | NC
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