MEDICARE: MISS LEIGH BETH WOODMAN TIPPIT PHYSICAL THERAPIST

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	P13092	NC

General Provider Information

NPI Number	:	1407041718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS LEIGH BETH WOODMAN TIPPIT PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	1417 PINEY MOUNTAIN RD
Second Line	:
City	:	WALNUT COVE
State	:	NC
Zip	:	27052-5604
Country	:	US
Telephone Number	:	336-671-6629
Fax Number	:

Provider Business Practice Location Address
First Line	:	1417 PINEY MOUNTAIN RD
Second Line	:
City	:	WALNUT COVE
State	:	NC
Zip	:	27052-5604
Country	:	US
Telephone Number	:	336-671-6629
Fax Number	:

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

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	05/27/2025

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