Provider Demographics
NPI:1841608056
Name:LEAVER, ERIN LEIGH (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:LEIGH
Last Name:LEAVER
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 E HIGH ST
Mailing Address - Street 2:APARTMENT 7
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-1835
Mailing Address - Country:US
Mailing Address - Phone:412-526-2654
Mailing Address - Fax:
Practice Address - Street 1:51 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-1258
Practice Address - Country:US
Practice Address - Phone:180-022-5739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0056732255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer