Provider Demographics
NPI:1154815041
Name:LEONE, STEPHEN (PT)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:LEONE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1238 TIMBER LN
Mailing Address - Street 2:
Mailing Address - City:GRAND CANE
Mailing Address - State:LA
Mailing Address - Zip Code:71032-5808
Mailing Address - Country:US
Mailing Address - Phone:318-455-8230
Mailing Address - Fax:
Practice Address - Street 1:406 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:TX
Practice Address - Zip Code:75494-3226
Practice Address - Country:US
Practice Address - Phone:903-342-6790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1137271225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist