Provider Demographics
NPI:1700170990
Name:LEATHERMAN, JOSHUA DALE (DPT)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:DALE
Last Name:LEATHERMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 MOYER RD
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-2313
Mailing Address - Country:US
Mailing Address - Phone:267-640-5773
Mailing Address - Fax:
Practice Address - Street 1:348 MOYER RD
Practice Address - Street 2:
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-2313
Practice Address - Country:US
Practice Address - Phone:267-640-5773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-05
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60266156225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist