Provider Demographics
NPI:1992714570
Name:STRAIT, LEIGH ELIZABETH (PT)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:ELIZABETH
Last Name:STRAIT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16645 BIRKDALE COMMONS PKWY
Mailing Address - Street 2:STE. 101
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-5669
Mailing Address - Country:US
Mailing Address - Phone:704-895-3636
Mailing Address - Fax:704-895-8436
Practice Address - Street 1:16645 BIRKDALE COMMONS PKWY
Practice Address - Street 2:STE. 101
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-5669
Practice Address - Country:US
Practice Address - Phone:704-895-3636
Practice Address - Fax:704-895-8436
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028392-1225100000X
NC13104225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB1338Medicare PIN