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Individual

MRS. SUSAN MEADOWS LEATHERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
717 N JEFFERSON ST, LEWISBURG, WV 24901
(304) 645-2525
(304) 645-2820
Mailing address
15 UNDERWOOD ROAD, LEWISBURG, WV 24901
(304) 667-1040

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002237
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001814354
MT ST BC AND BS
WV
05
3810005149
WV
Enumeration date
07/31/2006
Last updated
08/29/2013
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