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NPI Code Detail

MEDICARE: DAVID VAN LE PT, DPT

MEDICARE: DAVID VAN LE PT, 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
1225100000XPhysical Therapist2305214664VA
2225100000XPhysical TherapistPT015762GA

General Provider Information

NPI Number : 1598433252
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID VAN LE PT, DPT
Provider Business Mailing Address
First Line : 6397 LEE HWY
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37421-2564
Country : US
Telephone Number : 423-238-3473
Fax Number :
Provider Business Practice Location Address
First Line : 2065 GRAYSON HWY STE B
Second Line :
City : GRAYSON
State : GA
Zip : 30017-1766
Country : US
Telephone Number : 678-376-0213
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2021
Last Update Date : 02/09/2022

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