Provider Demographics
NPI:1275624249
Name:LEBLANC, GREG JOSEPH (PT, OCS)
Entity Type:Individual
Prefix:MR
First Name:GREG
Middle Name:JOSEPH
Last Name:LEBLANC
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Gender:M
Credentials:PT, OCS
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Mailing Address - Street 1:5414 BRITTANY DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-9124
Mailing Address - Country:US
Mailing Address - Phone:225-769-3898
Mailing Address - Fax:225-231-3813
Practice Address - Street 1:5414 BRITTANY DR
Practice Address - Street 2:SUITE G
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-9124
Practice Address - Country:US
Practice Address - Phone:225-769-3898
Practice Address - Fax:225-231-3813
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA044452251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic