Provider Demographics
NPI:1629577465
Name:LEONS, ANIT (PT)
Entity type:Individual
Prefix:
First Name:ANIT
Middle Name:
Last Name:LEONS
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 1:205 S OLIVER ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-1507
Mailing Address - Country:US
Mailing Address - Phone:316-612-4900
Mailing Address - Fax:316-612-4999
Practice Address - Street 1:545 N CARRIAGE PKWY
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-4506
Practice Address - Country:US
Practice Address - Phone:316-612-4900
Practice Address - Fax:316-612-4999
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-05802225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist