Provider Demographics
NPI:1740500362
Name:GEYER, LESLEY AUSTIN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:LESLEY
Middle Name:AUSTIN
Last Name:GEYER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 MEADOWVIEW DR
Mailing Address - Street 2:
Mailing Address - City:TRAPPE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-2145
Mailing Address - Country:US
Mailing Address - Phone:610-409-0833
Mailing Address - Fax:610-409-0833
Practice Address - Street 1:3075 W RIDGE PIKE
Practice Address - Street 2:
Practice Address - City:EAGLEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19403-1534
Practice Address - Country:US
Practice Address - Phone:610-265-4700
Practice Address - Fax:610-878-9318
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC000017L171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor