Provider Demographics
NPI:1699886333
Name:GIAQUINTA, LEAH JAYNE (PT)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:JAYNE
Last Name:GIAQUINTA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2591 44TH ST SE STE 101
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49512-9094
Mailing Address - Country:US
Mailing Address - Phone:616-281-9237
Mailing Address - Fax:616-281-3115
Practice Address - Street 1:2591 44TH ST SE STE 101
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49512-9094
Practice Address - Country:US
Practice Address - Phone:616-281-9237
Practice Address - Fax:616-281-3115
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501011912225100000X
IN05007800A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist