Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | TE010088 | PA |
NPI | 1063836245 |
---|---|
Provider Name | Katie Leeper |
First Address | Lancaster, PA 17601-3321 |
Second Address | Lancaster, PA 17601-3321 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2014 |
Last Update Date | 10/02/2014 |