Provider Demographics
NPI:1194248658
Name:JASON, LEANNA (PT, DPT)
Entity type:Individual
Prefix:
First Name:LEANNA
Middle Name:
Last Name:JASON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:LEANNA
Other - Middle Name:
Other - Last Name:FARNAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:94 PARKER ST APT 3
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-4423
Mailing Address - Country:US
Mailing Address - Phone:585-748-0289
Mailing Address - Fax:
Practice Address - Street 1:94 PARKER ST APT 3
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-4423
Practice Address - Country:US
Practice Address - Phone:585-748-0289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4245225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist