Provider Demographics
NPI:1598995524
Name:LEFFLER, MARK THOMAS (ATC)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:THOMAS
Last Name:LEFFLER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 S UNION ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44325-6302
Mailing Address - Country:US
Mailing Address - Phone:330-972-5528
Mailing Address - Fax:330-972-5253
Practice Address - Street 1:289 S UNION ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44325-6302
Practice Address - Country:US
Practice Address - Phone:330-972-5528
Practice Address - Fax:330-972-5253
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT-29792255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer