Provider Demographics
NPI:1033200381
Name:POWERS, LESLEY MCSHEA (DPT)
Entity Type:Individual
Prefix:DR
First Name:LESLEY
Middle Name:MCSHEA
Last Name:POWERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:LESLEY
Other - Middle Name:ANN
Other - Last Name:MCSHEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1247 WASHINGTON RD STE 28
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NH
Mailing Address - Zip Code:03870-2345
Mailing Address - Country:US
Mailing Address - Phone:603-379-2480
Mailing Address - Fax:603-379-2485
Practice Address - Street 1:1247 WASHINGTON RD
Practice Address - Street 2:SUITE 7
Practice Address - City:RYE
Practice Address - State:NH
Practice Address - Zip Code:03870-2346
Practice Address - Country:US
Practice Address - Phone:603-379-2480
Practice Address - Fax:603-379-2485
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2020-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17707225100000X
NH3321225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY69817Medicare PIN