Doctor Name: | LESLIE D FADDIS |
NPI Number: | 1568440162 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 8549 |
Business Practice Address: | 789 Main St Ste 4 Great Barrington Physical Therapy, Inc. Gt Barrington, MA - 012302217 |
Business Phone Number: | 4135280929 |
Business Fax Number: | 4135286123 |
Mailing Address: | 789 Main St Ste 4, Great Barrington Physical Therapy, Inc. GT BARRINGTON |
State: | MA |
Postal Code: | 012302217 |
Phone Number: | 4135280929 |
Fax Number: | 4135286123 |
NPI Enumeration Date: | 01/04/2006 |
NPI Last Update Date: | 10/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 8549 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
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 |