Provider Demographics
NPI:1952169922
Name:LEISY, ALISON HORD (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:HORD
Last Name:LEISY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:SINCLAIR
Other - Last Name:HORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2000 BREMO RD STE 102
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2440
Mailing Address - Country:US
Mailing Address - Phone:949-554-3905
Mailing Address - Fax:
Practice Address - Street 1:2000 BREMO RD STE 102
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2440
Practice Address - Country:US
Practice Address - Phone:949-554-3905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019018085225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist