Provider Demographics
NPI:1710285564
Name:SMITH, LEIGH (PT)
Entity Type:Individual
Prefix:MRS
First Name:LEIGH
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1142 GREER DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38019-2304
Mailing Address - Country:US
Mailing Address - Phone:901-497-6078
Mailing Address - Fax:
Practice Address - Street 1:1921 HIGHWAY 51 S
Practice Address - Street 2:UNIT C & D
Practice Address - City:COVINGTON
Practice Address - State:TN
Practice Address - Zip Code:38019-3659
Practice Address - Country:US
Practice Address - Phone:901-476-0491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6092225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist