Provider Demographics
NPI:1598569360
Name:LEBLANC, KATLYN MICHELLE (DPT, PT)
Entity type:Individual
Prefix:
First Name:KATLYN
Middle Name:MICHELLE
Last Name:LEBLANC
Suffix:
Gender:
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:203 NARROWS PKWY STE D
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-8649
Mailing Address - Country:US
Mailing Address - Phone:770-683-5042
Mailing Address - Fax:678-877-8444
Practice Address - Street 1:1575 HIGHWAY 34 E STE B
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2401
Practice Address - Country:US
Practice Address - Phone:770-683-5042
Practice Address - Fax:678-877-8444
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPENDING225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist