Provider Demographics
NPI:1568831469
Name:CUELLAR, LEIGHA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:LEIGHA
Middle Name:
Last Name:CUELLAR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 WOLVERINE TRL STE 201
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-5656
Mailing Address - Country:US
Mailing Address - Phone:615-220-5796
Mailing Address - Fax:615-220-8829
Practice Address - Street 1:301 WOLVERINE TRL STE 201
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-5656
Practice Address - Country:US
Practice Address - Phone:615-220-5796
Practice Address - Fax:615-220-8829
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10495225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist