Provider Demographics
NPI:1578157798
Name:LEGGETT, RICHARD WHITFIELD (PT, DPT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:WHITFIELD
Last Name:LEGGETT
Suffix:
Gender:M
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 1:1632 BROOK HOLLOW DR APT A
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-8590
Mailing Address - Country:US
Mailing Address - Phone:252-799-9047
Mailing Address - Fax:
Practice Address - Street 1:2756 US HIGHWAY 64 E
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NC
Practice Address - Zip Code:27962-8903
Practice Address - Country:US
Practice Address - Phone:252-791-1006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-28
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP20279225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist