Provider Demographics
NPI:1811209497
Name:CARBONE, LEANNE CHRISTINA (DPT)
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:CHRISTINA
Last Name:CARBONE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LEANNE
Other - Middle Name:CHRISTINA
Other - Last Name:SALT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:4833 HIGHWAY 58
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37416-1826
Practice Address - Country:US
Practice Address - Phone:423-553-7972
Practice Address - Fax:423-553-7973
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT8901225100000X
GA9973225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist