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Organization
LEIS THERAPY LLC
Active
Organization
LEIS THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN ASHLEY LEIS PT (PHYSICAL THERAPIST)
(301) 526-9014
Entity
Organization
Contact information
Practice address
1617 ONSLOW DR, CHARLOTTE, NC 28205
(301) 526-9014
Mailing address
1617 ONSLOW DR, CHARLOTTE, NC 28205
(301) 526-9014
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251N0400X
Neurology Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19QMF
BCBC
NC
Enumeration date
12/28/2018
Last updated
12/28/2018
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