MEDICARE: KELLY L LEININGER DPT

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	PT870799	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT870799	OTHER	DC	LICENSE NUMBER
2	1215951280	OTHER		NPI

General Provider Information

NPI Number	:	1215951280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY L LEININGER DPT

Provider Business Mailing Address
First Line	:	1100 H ST NW
Second Line	:	SUITE LL110
City	:	WASHINGTON
State	:	DC
Zip	:	20005
Country	:	US
Telephone Number	:	202-347-2373
Fax Number	:	202-347-2375

Provider Business Practice Location Address
First Line	:	1100 H ST NW STE LL110
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20005-5476
Country	:	US
Telephone Number	:	202-347-2373
Fax Number	:	202-347-2375

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/21/2022

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