Provider Demographics
NPI:1669281523
Name:LEAP PEDIATRIC THERAPY LLC
Entity type:Organization
Organization Name:LEAP PEDIATRIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSCICKI
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:205-202-9551
Mailing Address - Street 1:2020 HIGHWAY 33
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-4890
Mailing Address - Country:US
Mailing Address - Phone:205-202-9551
Mailing Address - Fax:205-377-7177
Practice Address - Street 1:2020 HIGHWAY 33 UNIT A
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-4891
Practice Address - Country:US
Practice Address - Phone:205-202-9551
Practice Address - Fax:205-377-7177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-06
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy