Provider Demographics
NPI:1558420448
Name:LEBLANC, ANDREW P (MPT)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:P
Last Name:LEBLANC
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2820 HEARNE AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103-3934
Mailing Address - Country:US
Mailing Address - Phone:318-631-7999
Mailing Address - Fax:318-631-9528
Practice Address - Street 1:2820 HEARNE AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-3934
Practice Address - Country:US
Practice Address - Phone:318-631-7999
Practice Address - Fax:318-631-9528
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA070782251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic