Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 003650 | CT |
N | 2251S0007X | Physical Therapist - Sports | 4631 | NC |
NPI | 1518946052 |
---|---|
Provider Name | Michele Leavitt Weinstein |
First Address | Alexandria, VA 22310-4333 |
Second Address | Quantico, VA 22134-5109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2006 |
Last Update Date | 08/07/2007 |