Provider Demographics
NPI:1427335322
Name:LEAMON, KRISTOFFER LEE (PT, DPT, LAT, ATC)
Entity type:Individual
Prefix:
First Name:KRISTOFFER
Middle Name:LEE
Last Name:LEAMON
Suffix:
Gender:
Credentials:PT, DPT, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 DICKS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:NC
Mailing Address - Zip Code:28789-7949
Mailing Address - Country:US
Mailing Address - Phone:828-506-0604
Mailing Address - Fax:
Practice Address - Street 1:1211 VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1313
Practice Address - Country:US
Practice Address - Phone:336-275-0927
Practice Address - Fax:336-275-4834
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18902255A2300X
NCP16125225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer