MEDICARE: ELENA STRONG 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
1	2251P0200X	Pediatric Physical Therapist	PT007997	GA

General Provider Information

NPI Number	:	1821278730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELENA STRONG LEONARD

Provider Business Mailing Address
First Line	:	PO BOX 28528
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30358-0528
Country	:	US
Telephone Number	:	404-247-7959
Fax Number	:	404-459-6566

Provider Business Practice Location Address
First Line	:	3285 PINE MEADOW RD NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30327-2217
Country	:	US
Telephone Number	:	404-822-8519
Fax Number	:

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

Provider Enumeration Date	:	11/07/2007
Last Update Date	:	11/07/2007

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Directions to “ ELENA STRONG LEONARD ” Practice Location

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