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Individual
MR. KENNETH AIDEN LEACOCK
Active
Individual
MR. KENNETH AIDEN LEACOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
007365
NY
2251X0800X
Orthopedic Physical Therapist
Primary
007365
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007365
P.T. LICENCE
NY
Enumeration date
12/27/2005
Last updated
09/11/2025
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