Provider Demographics
NPI:1619531829
Name:GUNN, LEANNA (DPT)
Entity Type:Individual
Prefix:
First Name:LEANNA
Middle Name:
Last Name:GUNN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 N GUIGNARD DR
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-2423
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:795 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NH
Practice Address - Zip Code:03870-2318
Practice Address - Country:US
Practice Address - Phone:603-964-8144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH5064225100000X
SC8939225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist