Individual
KATIE E LEISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
112 ETNA RD, LEBANON, NH 03766-1454
(603) 643-7788
(603) 643-0022
Mailing address
PO BOX 727, LEBANON, NH 03766-0727
(603) 643-7788
(603) 643-0022
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
008176
CT
225100000X
Physical Therapist
Primary
3350
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000685101
MEDICARE PTAN
NH
05
—
3100041
—
NH
Enumeration date
04/02/2008
Last updated
08/24/2016
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