Provider Demographics
NPI:1982219085
Name:LEGGETT, RALPH W
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:W
Last Name:LEGGETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4261 INDUSTRY RD
Mailing Address - Street 2:
Mailing Address - City:ROOTSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44272-9532
Mailing Address - Country:US
Mailing Address - Phone:330-221-8159
Mailing Address - Fax:
Practice Address - Street 1:4261 INDUSTRY RD
Practice Address - Street 2:
Practice Address - City:ROOTSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44272-9532
Practice Address - Country:US
Practice Address - Phone:330-221-8159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker