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General NPI Number Information
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NPI Number | 1912488925
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Entity Type | Individual
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Provider Name | NOELLE ELIZABETH LEIGHTY PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/27/2018
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Last Update Date | 08/27/2018
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Provider Practice Location Address
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Address Line | 2125 ROYCE ST
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City | PORTSMOUTH
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State | OH
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Zip | 45662-4714
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Country | US
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Telephone | 740-354-6635
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Fax |
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Provider Business Mailing Address
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Address Line | 246 TOWNSHIP ROAD 1214
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City | IRONTON
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State | OH
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Zip | 45638-8809
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Country | US
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Telephone | 740-646-3410
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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 | PT017671
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License Number State | OH
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