Provider Demographics
NPI:1114182508
Name:HOEY, LESLEY T (PT)
Entity Type:Individual
Prefix:MS
First Name:LESLEY
Middle Name:T
Last Name:HOEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 PRESERVATION LN UNIT 7
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-6455
Mailing Address - Country:US
Mailing Address - Phone:207-874-0491
Mailing Address - Fax:
Practice Address - Street 1:16 THOMPSON ST
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-3021
Practice Address - Country:US
Practice Address - Phone:207-874-0491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT3432225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist