Provider Demographics
NPI:1043226616
Name:CALDWELL, LEIGH ANN (MBA, ATC, LAT)
Entity Type:Individual
Prefix:MS
First Name:LEIGH
Middle Name:ANN
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:MBA, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 PONDSIDE DR
Mailing Address - Street 2:PO BOX 5002
Mailing Address - City:WINGATE
Mailing Address - State:NC
Mailing Address - Zip Code:28174-9683
Mailing Address - Country:US
Mailing Address - Phone:704-363-8622
Mailing Address - Fax:704-233-8295
Practice Address - Street 1:909 PONDSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:WINGATE
Practice Address - State:NC
Practice Address - Zip Code:28174-0165
Practice Address - Country:US
Practice Address - Phone:704-233-8165
Practice Address - Fax:704-233-8295
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC712255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer