| Organization Name: | LESLIE K MCKIBBEN RPT ASSOC |
| NPI Number: | 1497841621 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LESLIE K MCKIBBEN (PRESIDENT) |
| Mailing Address: | 4640 Whipple Hollow Rd Melbourne |
| State: | FL US |
| Postal Code: | 329347661 |
| Phone Number: | 3212595592 |
| Fax Number: | 3212595592 |
| NPI Enumeration Date: | 10/05/2006 |
| NPI Last Update Date: | 04/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | FL5166 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| 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 |