Doctor Name: | DIANNE MICHELLE LECKWOLD |
NPI Number: | 1881941102 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | PT005200 |
Business Practice Address: | 756 Neese Rd Woodstock, GA - 301884297 |
Business Phone Number: | 7705175513 |
Business Fax Number: | 7705175513 |
Mailing Address: | 2222 Sullivan Trl, EASTON |
State: | PA |
Postal Code: | 180407958 |
Phone Number: | 8009449782 |
Fax Number: | 6104382046 |
NPI Enumeration Date: | 08/06/2012 |
NPI Last Update Date: | 08/06/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT005200 |
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 |