Provider Demographics
NPI:1629156674
Name:DOBBS, LESLIE J (PT)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:J
Last Name:DOBBS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:J
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:525 S 60TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-5994
Mailing Address - Country:US
Mailing Address - Phone:515-400-2957
Mailing Address - Fax:
Practice Address - Street 1:525 S 60TH ST
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-5994
Practice Address - Country:US
Practice Address - Phone:515-400-2957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28314225100000X
IA02897225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI7658OtherMEDICARE GROUP NUMBER
IAI22050Medicare PIN