| Doctor Name: | MR. MATTHEW LEBLANG |
| NPI Number: | 1639421746 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T |
| License Number: | 05010823A |
| Business Practice Address: | 1005 N Hickory Rd South Bend, IN - 466153723 |
| Business Phone Number: | 5742335754 |
| Business Fax Number: | 5742337406 |
| Mailing Address: | 1005 N Hickory Rd, SOUTH BEND |
| State: | IN |
| Postal Code: | 466153723 |
| Phone Number: | 5742335754 |
| Fax Number: | 5742337406 |
| NPI Enumeration Date: | 10/12/2012 |
| NPI Last Update Date: | 05/10/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 05010823A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| 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 |