Provider Demographics
NPI:1659939874
Name:CELIAN, LEAH TREASURE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:TREASURE
Last Name:CELIAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:TREASURE
Other - Last Name:RIDGWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:293 JEFFERSON DR
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:VA
Mailing Address - Zip Code:22963-2601
Mailing Address - Country:US
Mailing Address - Phone:941-321-7818
Mailing Address - Fax:
Practice Address - Street 1:4238 JAMES MADISON HWY
Practice Address - Street 2:
Practice Address - City:FORK UNION
Practice Address - State:VA
Practice Address - Zip Code:23055
Practice Address - Country:US
Practice Address - Phone:434-842-2916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31380225100000X
VA2305212639225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist