# LEADING EDGE PHYSICAL THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982313995
- **Authorized official:** MATTHEW HENNINGS DPT (OWNER)
- **Authorized official phone:** (503) 500-5727

## Contact information

- **Practice address:** 1100 LIBERTY ST SE STE 100, SALEM, OR 97302-5385
- **Practice address phone:** (503) 500-5727
- **Practice address fax:** (971) 273-2706
- **Mailing address:** 5477 BELLFLOWER ST SE, SALEM, OR 97306-1648
- **Mailing address phone:** (503) 500-5727

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/17/2022
- **Last updated:** 10/06/2023