Provider Demographics
NPI:1215100128
Name:LEIGHTON, JOSE L (DPT)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:L
Last Name:LEIGHTON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:DR
Other - First Name:JOSE
Other - Middle Name:L
Other - Last Name:LEYTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:406 S LANDMARK AVE
Mailing Address - Street 2:JMC PHYSICAL THERAPY, LLC
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47404
Mailing Address - Country:US
Mailing Address - Phone:812-320-2242
Mailing Address - Fax:812-332-4562
Practice Address - Street 1:406 S LANDMARK AVE
Practice Address - Street 2:JMC PHYSICAL THERAPY, LLC
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404
Practice Address - Country:US
Practice Address - Phone:812-320-2242
Practice Address - Fax:812-332-4562
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0500504A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist