Provider Demographics
NPI:1407041718
Name:TIPPIT, LEIGH BETH WOODMAN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MISS
First Name:LEIGH
Middle Name:BETH WOODMAN
Last Name:TIPPIT
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1417 PINEY MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:WALNUT COVE
Mailing Address - State:NC
Mailing Address - Zip Code:27052-5604
Mailing Address - Country:US
Mailing Address - Phone:336-671-6629
Mailing Address - Fax:
Practice Address - Street 1:1417 PINEY MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:WALNUT COVE
Practice Address - State:NC
Practice Address - Zip Code:27052-5604
Practice Address - Country:US
Practice Address - Phone:336-671-6629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP13092225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist