Provider Demographics
NPI:1912488925
Name:LEIGHTY, NOELLE ELIZABETH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:ELIZABETH
Last Name:LEIGHTY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 TOWNSHIP ROAD 1214
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-8809
Mailing Address - Country:US
Mailing Address - Phone:740-646-3410
Mailing Address - Fax:
Practice Address - Street 1:2125 ROYCE ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-4714
Practice Address - Country:US
Practice Address - Phone:740-354-6635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT017671225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist