Provider Demographics
NPI:1609325067
Name:RICE, LEAH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:RICE
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 1:1101 GOLF COURSE RD SE STE 201
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-4731
Mailing Address - Country:US
Mailing Address - Phone:505-896-0835
Mailing Address - Fax:
Practice Address - Street 1:1101 GOLF COURSE RD SE STE 201
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-4731
Practice Address - Country:US
Practice Address - Phone:505-896-0835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4906225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist