Provider Demographics
NPI:1689803850
Name:BRANT, LESLIE ROSE (DPT)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ROSE
Last Name:BRANT
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 1:85 PAINE ST SE STE B
Mailing Address - Street 2:
Mailing Address - City:BONDURANT
Mailing Address - State:IA
Mailing Address - Zip Code:50035-1154
Mailing Address - Country:US
Mailing Address - Phone:515-528-2326
Mailing Address - Fax:515-528-2327
Practice Address - Street 1:85 PAINE ST SE STE B
Practice Address - Street 2:
Practice Address - City:BONDURANT
Practice Address - State:IA
Practice Address - Zip Code:50035-1154
Practice Address - Country:US
Practice Address - Phone:515-528-2326
Practice Address - Fax:515-528-2327
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004437225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist