Basic Information
Provider Information
NPI: 1275086928
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TURNIPSEED
FirstName: LEIGH
MiddleName: GARRETT
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: GARRETT
OtherFirstName: LEIGH
OtherMiddleName: ALEXANDRA
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 2416 HIGHWAY 45 N
Address2:  
City: COLUMBUS
State: MS
PostalCode: 397051320
CountryCode: US
TelephoneNumber: 6623276705
FaxNumber: 6623276760
Practice Location
Address1: 110 N WALMART DR
Address2: SUITE F
City: LOUISVILLE
State: MS
PostalCode: 393395905
CountryCode: US
TelephoneNumber: 6627791096
FaxNumber: 6627793949
Other Information
ProviderEnumerationDate: 07/29/2016
LastUpdateDate: 07/29/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT2927MSY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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