MEDICARE: MR. DANIEL ALBERT LEONARD 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	172V00000X	Community Health Worker	PT013059L	PA

General Provider Information

NPI Number	:	1760659098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIEL ALBERT LEONARD PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	1301 S 3RD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-6008
Country	:	US
Telephone Number	:	215-467-2120
Fax Number	:	215-467-3620

Provider Business Practice Location Address
First Line	:	1301 S 3RD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-6008
Country	:	US
Telephone Number	:	215-467-2120
Fax Number	:	215-467-3620

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

Provider Enumeration Date	:	05/15/2008
Last Update Date	:	05/15/2008

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