Provider Demographics
NPI:1396246872
Name:HAGERTY, LESLIE ERIN (DPT)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:ERIN
Last Name:HAGERTY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14231 BEADLE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-8213
Mailing Address - Country:US
Mailing Address - Phone:269-704-5180
Mailing Address - Fax:269-704-5185
Practice Address - Street 1:14231 BEADLE LAKE RD
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-8213
Practice Address - Country:US
Practice Address - Phone:269-704-5180
Practice Address - Fax:269-704-5185
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017988225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist