Provider Demographics
NPI:1154929024
Name:LEGGETT, SHELBY (PT, DPT, COMT)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:LEGGETT
Suffix:
Gender:F
Credentials:PT, DPT, COMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2019B LEIGHTON DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-4854
Mailing Address - Country:US
Mailing Address - Phone:919-440-9738
Mailing Address - Fax:
Practice Address - Street 1:2340 HEMBY LN STE 200
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3792
Practice Address - Country:US
Practice Address - Phone:252-758-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP19694225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist