Provider Demographics
NPI:1225576200
Name:LEFFINGWELL, NATALIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:LEFFINGWELL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2999 DYKE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705
Mailing Address - Country:US
Mailing Address - Phone:614-746-8871
Mailing Address - Fax:
Practice Address - Street 1:157 LEWIS ST
Practice Address - Street 2:
Practice Address - City:NORTH POLE
Practice Address - State:AK
Practice Address - Zip Code:99705-7699
Practice Address - Country:US
Practice Address - Phone:907-488-4978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH015516225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist