Provider Demographics
NPI:1104424761
Name:PRATT, LEONARD (PTPHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:
Last Name:PRATT
Suffix:
Gender:M
Credentials:PTPHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 COBBLE ROAD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06068
Mailing Address - Country:US
Mailing Address - Phone:860-435-4537
Mailing Address - Fax:860-435-1438
Practice Address - Street 1:17 COBBLE ROAD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:CT
Practice Address - Zip Code:06068
Practice Address - Country:US
Practice Address - Phone:860-435-4537
Practice Address - Fax:860-435-1438
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist