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NPI Code Detail

MEDICARE: JUSTIN CHARLES LEGGETT PT

MEDICARE: JUSTIN CHARLES LEGGETT PT
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
1225100000XPhysical TherapistP19281NC

General Provider Information

NPI Number : 1124667480
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN CHARLES LEGGETT PT
Provider Business Mailing Address
First Line : 2126 WAYNE MEMORIAL DR
Second Line :
City : GOLDSBORO
State : NC
Zip : 27534-1722
Country : US
Telephone Number : 919-766-9022
Fax Number : 919-709-0433
Provider Business Practice Location Address
First Line : 2126 WAYNE MEMORIAL DR
Second Line :
City : GOLDSBORO
State : NC
Zip : 27534-1722
Country : US
Telephone Number : 919-766-9022
Fax Number : 919-709-0433
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2020
Last Update Date : 01/23/2020

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