Provider Demographics
NPI:1457035990
Name:LEPPERT, JOHN MICHAEL (MS, AT, CSCS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:MICHAEL
Last Name:LEPPERT
Suffix:
Gender:M
Credentials:MS, AT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9436 MCKINNEY RD
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-9028
Mailing Address - Country:US
Mailing Address - Phone:901-359-1592
Mailing Address - Fax:
Practice Address - Street 1:6905 GIVEN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45243-2839
Practice Address - Country:US
Practice Address - Phone:513-561-7298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16142255A2300X
OHAT0067432255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer