Provider Demographics
NPI:1851449441
Name:TOULOUSE, LESLIE H (PT)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:H
Last Name:TOULOUSE
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 1:10580 N MCCARRAN BLVD # 115-143
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-1895
Mailing Address - Country:US
Mailing Address - Phone:775-345-0828
Mailing Address - Fax:775-345-0825
Practice Address - Street 1:1400 BARING BLVD
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-1642
Practice Address - Country:US
Practice Address - Phone:775-750-9735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV208100000X208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVRPT809Medicare PIN