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NPI Code Detail

MEDICARE: LISA LEONARD

MEDICARE: LISA LEONARD
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 Therapist2670NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12670OTHERNVPT LICENSE

General Provider Information

NPI Number : 1457752586
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA LEONARD
Provider Business Mailing Address
First Line : 10105 BANBURRY CROSS DR STE 445
Second Line :
City : LAS VEGAS
State : NV
Zip : 89144-6645
Country : US
Telephone Number : 205-259-3991
Fax Number :
Provider Business Practice Location Address
First Line : 10105 BANBURRY CROSS DR STE 445
Second Line :
City : LAS VEGAS
State : NV
Zip : 89144-6645
Country : US
Telephone Number : 205-259-3991
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2014
Last Update Date : 09/08/2014

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Directions to “ LISA LEONARD ” Practice Location

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