Provider Demographics
NPI:1235319559
Name:LEONARD, CARA BENSON (PT)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:BENSON
Last Name:LEONARD
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 1:14728 ROBIN CIR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-8526
Mailing Address - Country:US
Mailing Address - Phone:405-350-1155
Mailing Address - Fax:
Practice Address - Street 1:14728 ROBIN CIR
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-8526
Practice Address - Country:US
Practice Address - Phone:405-350-1155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3988225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist