Provider Demographics
NPI:1619990686
Name:PARRISH, LESLEY REDDING (PT)
Entity type:Individual
Prefix:MRS
First Name:LESLEY
Middle Name:REDDING
Last Name:PARRISH
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 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3230 STADIUM TOWER
Practice Address - Street 2:
Practice Address - City:TROY UNIVERSITY
Practice Address - State:AL
Practice Address - Zip Code:36082
Practice Address - Country:US
Practice Address - Phone:334-403-6268
Practice Address - Fax:334-403-6269
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT 6726225100000X
ALPTH6694225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist