Provider Demographics
NPI:1841671195
Name:LELAND, JESSICA (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:LELAND
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:WOODWORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:82 PALOMINO LN STE 701
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6448
Mailing Address - Country:US
Mailing Address - Phone:603-810-0670
Mailing Address - Fax:603-810-0678
Practice Address - Street 1:82 PALOMINO LN STE 701
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6448
Practice Address - Country:US
Practice Address - Phone:603-810-0670
Practice Address - Fax:603-810-0678
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2024-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21720225100000X
NH3974225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist