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Individual
LESLEY THROCKMORTON
Active
Individual
LESLEY THROCKMORTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, LMT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1181247
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
838T42
BCBS
TX
Enumeration date
03/10/2010
Last updated
12/06/2013
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