Provider Demographics
NPI:1295081958
Name:LEONARD, LAURA LINDSAY (DPT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LINDSAY
Last Name:LEONARD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:LINDSAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 NEW FIDELITY CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2665
Mailing Address - Country:US
Mailing Address - Phone:919-258-2714
Mailing Address - Fax:410-987-2975
Practice Address - Street 1:34 W VIRGINIA WAY STE 1
Practice Address - Street 2:
Practice Address - City:RANSON
Practice Address - State:WV
Practice Address - Zip Code:25438-4882
Practice Address - Country:US
Practice Address - Phone:304-728-9090
Practice Address - Fax:304-728-9087
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24121225100000X
WVPT003907225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist