Basic Information
Provider Information
NPI: 1831118637
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARPER
FirstName: LESLEE
MiddleName: KAY
NamePrefix:  
NameSuffix:  
Credential: P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7235 OHMS LN
Address2:  
City: EDINA
State: MN
PostalCode: 554392148
CountryCode: US
TelephoneNumber: 9528412345
FaxNumber: 9528412346
Practice Location
Address1: 2620 EAGAN WOODS DR STE 200
Address2:  
City: EAGAN
State: MN
PostalCode: 551211138
CountryCode: US
TelephoneNumber: 6519685600
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/19/2006
LastUpdateDate: 04/15/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X6830MNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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