Provider Demographics
NPI:1508225533
Name:COLLINS, LESLIE PERRY (PT)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:PERRY
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6252 US HIGHWAY 68
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056-8648
Mailing Address - Country:US
Mailing Address - Phone:606-776-5855
Mailing Address - Fax:
Practice Address - Street 1:6252 US HIGHWAY 68
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-8648
Practice Address - Country:US
Practice Address - Phone:606-776-5855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-18
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005492225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist