Provider Demographics
NPI:1750457263
Name:BOUNDS, LEAH (PTA)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:BOUNDS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10776 GRAYS CORNER RD 4
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811-3561
Mailing Address - Country:US
Mailing Address - Phone:410-641-2900
Mailing Address - Fax:410-641-2914
Practice Address - Street 1:10776 GRAYS CORNER RD 4
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-3561
Practice Address - Country:US
Practice Address - Phone:410-641-2900
Practice Address - Fax:410-641-2914
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA2461225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant