MEDICARE: MRS. LEAH J. BARBER MSPT

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	2305005652	VA
2	225100000X	Physical Therapist	2305005652

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2305005652	OTHER	VA	VA STATE LICENSE

General Provider Information

NPI Number	:	1467451138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LEAH J. BARBER MSPT

Provider Business Mailing Address
First Line	:	10504 WAKEMAN DR
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22407-8040
Country	:	US
Telephone Number	:	540-891-5326
Fax Number	:	540-891-6316

Provider Business Practice Location Address
First Line	:	10504 WAKEMAN DR
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22407-8040
Country	:	US
Telephone Number	:	540-891-5326
Fax Number	:	540-891-6316

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

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	05/10/2018

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