Provider Demographics
NPI:1487071890
Name:STEWART, LESLEY LYNN (PT, DPT)
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:LYNN
Last Name:STEWART
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 KETTLE CREEK ROAD SUITE C
Mailing Address - Street 2:RESPONSIVE PHYSICAL THERAPY, INC.
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 KETTLE CREEK RD. SUITE C
Practice Address - Street 2:RESPONSIVE PHYSICAL THERAPY, INC.
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753
Practice Address - Country:US
Practice Address - Phone:732-255-7404
Practice Address - Fax:732-255-7406
Is Sole Proprietor?:No
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA003220002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic