Provider Demographics
NPI:1558676437
Name:BULEY, LESLEY A (PT)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:A
Last Name:BULEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LESLEY
Other - Middle Name:A
Other - Last Name:CORBETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 922
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-0922
Mailing Address - Country:US
Mailing Address - Phone:866-309-5567
Mailing Address - Fax:812-491-1269
Practice Address - Street 1:340 STARLITE DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-6102
Practice Address - Country:US
Practice Address - Phone:812-437-1420
Practice Address - Fax:270-212-3073
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05010392A225100000X
KY005946225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist