Basic Information
Provider Information
NPI: 1730847732
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARTER
FirstName: LEAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 306393
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372306393
CountryCode: US
TelephoneNumber: 6153731350
FaxNumber: 6153737116
Practice Location
Address1: 4027 HILLSBORO PIKE STE 801
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372152734
CountryCode: US
TelephoneNumber: 6153852201
FaxNumber: 6153838590
Other Information
ProviderEnumerationDate: 12/07/2021
LastUpdateDate: 12/07/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/07/2021

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

No ID Information.


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