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General NPI Number Information
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NPI Number | 1982777025
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Entity Type | Individual
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Provider Name | CARLA ANN LEYEN MSPT, MOMT
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Gender | Female
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 100 LINDSEY LN STE A
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City | SAINT MARYS
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State | GA
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Zip | 31558-1727
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Country | US
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Telephone | 912-729-1333
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Fax | 912-729-5259
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Provider Business Mailing Address
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Address Line | 802 PARK ST
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City | REINBECK
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State | IA
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Zip | 50669-1224
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Country | US
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Telephone | 319-345-2963
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Fax | 319-334-6166
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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 | 02243
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License Number State | IA
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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 | CPO37378T
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License Number State | GA
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