Provider Demographics
NPI:1194840413
Name:GENTLE, LEA A (PT)
Entity Type:Individual
Prefix:
First Name:LEA
Middle Name:A
Last Name:GENTLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LEA
Other - Middle Name:A
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:542 FORESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WINTERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43953-9055
Mailing Address - Country:US
Mailing Address - Phone:740-266-6533
Mailing Address - Fax:
Practice Address - Street 1:840 LEE RD
Practice Address - Street 2:
Practice Address - City:FOLLANSBEE
Practice Address - State:WV
Practice Address - Zip Code:26037-1783
Practice Address - Country:US
Practice Address - Phone:304-527-1100
Practice Address - Fax:304-527-0909
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6918225100000X
WV001319225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist