Provider Demographics
NPI:1306684394
Name:FRALEY, LEAH LIXING (DPT)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:LIXING
Last Name:FRALEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 POINTE CIR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3505
Mailing Address - Country:US
Mailing Address - Phone:864-233-4477
Mailing Address - Fax:864-233-7844
Practice Address - Street 1:6717C STATE PARK RD
Practice Address - Street 2:
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690-1831
Practice Address - Country:US
Practice Address - Phone:864-610-9641
Practice Address - Fax:864-610-9644
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12424225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist