MEDICARE: LEADER PHYSICAL THERAPY LIMITED PARTNERSHIP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1114683562
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEADER PHYSICAL THERAPY LIMITED PARTNERSHIP

Provider Business Mailing Address
First Line	:	1204 N HOUSTON LEVEE RD STE 106
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38018-6687
Country	:	US
Telephone Number	:	901-410-8487
Fax Number	:	301-654-3288

Provider Business Practice Location Address
First Line	:	1204 N HOUSTON LEVEE RD STE 106
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38018-6687
Country	:	US
Telephone Number	:	901-410-8487
Fax Number	:	301-654-3288

Authorized Official
Title or Position	:	EVP
Name	:	RICHARD BINSTEIN
Credential	:
Telephone Number	:	713-297-7000

Provider Enumeration Date	:	11/10/2021
Last Update Date	:	11/10/2021

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