MEDICARE: LEAPS & BOUNDS, INC.

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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1144417965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEAPS & BOUNDS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 473414
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28247-3414
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17121 CLEMENTINE CT
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-2496
Country	:	US
Telephone Number	:	704-641-7193
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ERIN CAMPBELL
Credential	:
Telephone Number	:	704-641-7193

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	05/10/2013

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