Provider Demographics
NPI:1912957705
Name:MILLIGAN, LESLIE A (DPT)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:A
Last Name:MILLIGAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:A
Other - Last Name:CURREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:7338 RUTHVEN RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-3353
Mailing Address - Country:US
Mailing Address - Phone:504-400-0632
Mailing Address - Fax:
Practice Address - Street 1:620 JOHN PAUL JONES CIR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23708-2111
Practice Address - Country:US
Practice Address - Phone:757-953-1464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12952225100000X
OH011598225100000X
VA23052057242251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2305205724OtherPHYSICAL THERAPY LICENSE
CA12952OtherPHYSICAL THERAPY LICENSE