Provider Demographics
NPI:1942587852
Name:LEON, MARK ANDREW (DPT)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:ANDREW
Last Name:LEON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:1909 HINSON LOOP RD
Mailing Address - Street 2:STE 100
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-3903
Mailing Address - Country:US
Mailing Address - Phone:501-301-4530
Mailing Address - Fax:501-251-1165
Practice Address - Street 1:4300 LANDERS RD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2525
Practice Address - Country:US
Practice Address - Phone:501-771-1600
Practice Address - Fax:501-955-2252
Is Sole Proprietor?:No
Enumeration Date:2011-11-05
Last Update Date:2017-11-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AR3390225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist