Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology |
NPI | 1265929616 |
---|---|
Provider Name | Laura Leone |
First Address | Ypsilanti, MI 48197-1051 |
Second Address | Ypsilanti, MI 48197-1051 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2018 |
Last Update Date | 20/04/2018 |