Provider Demographics
NPI:1801925458
Name:WILLIAMS, LESLIE J (PT/DPT)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:J
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PT/DPT
Other - Prefix:MRS
Other - First Name:LESLIE
Other - Middle Name:J
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:322 NOTH BUCKMARSH ST.
Mailing Address - Street 2:SUITE A
Mailing Address - City:BERRYVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22611-1025
Mailing Address - Country:US
Mailing Address - Phone:540-955-1837
Mailing Address - Fax:540-955-1838
Practice Address - Street 1:322 NORTH BUCKMARSH ST.
Practice Address - Street 2:SUITE A
Practice Address - City:BERRYVILLE
Practice Address - State:VA
Practice Address - Zip Code:22611-1025
Practice Address - Country:US
Practice Address - Phone:540-955-1837
Practice Address - Fax:540-955-1838
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305003575225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA541636329OtherCOMMUNITY HEALTH
VA226164OtherBCBS
VA541636329OtherUHC
VA541636329OtherFIRST HEALTH
VACO5559Medicare ID - Type Unspecified