Provider Demographics
NPI:1063707016
Name:LEBLANC, JOSHUA C (DPT)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:C
Last Name:LEBLANC
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 392
Mailing Address - Street 2:
Mailing Address - City:WATSON
Mailing Address - State:LA
Mailing Address - Zip Code:70786
Mailing Address - Country:US
Mailing Address - Phone:225-275-9293
Mailing Address - Fax:225-275-7671
Practice Address - Street 1:35055 LA HWY 16
Practice Address - Street 2:STE 1-C
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70706
Practice Address - Country:US
Practice Address - Phone:225-791-7770
Practice Address - Fax:225-791-7725
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05010547A225100000X
LA08065225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist