| Doctor Name: | JESSICA SHANAHAN LEIVERS |
| NPI Number: | 1043441017 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | PT9710 |
| Business Practice Address: | 455 Philip Blvd Bldg 100 Suite 160 Lawrenceville, GA - 300468767 |
| Business Phone Number: | 6789850238 |
| Business Fax Number: | 6789850136 |
| Mailing Address: | 8823 Production Ln, OOLTEWAH |
| State: | TN |
| Postal Code: | 373636511 |
| Phone Number: | 4232387217 |
| Fax Number: | 4232383473 |
| NPI Enumeration Date: | 08/07/2009 |
| NPI Last Update Date: | 04/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT9710 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |