Provider Demographics
NPI:1144330911
Name:NASH, LEIGH ANNE (PT)
Entity type:Individual
Prefix:MRS
First Name:LEIGH
Middle Name:ANNE
Last Name:NASH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1180 SATELLITE BLVD NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-4636
Mailing Address - Country:US
Mailing Address - Phone:404-367-2080
Mailing Address - Fax:770-495-3493
Practice Address - Street 1:1180 SATELLITE BLVD NW
Practice Address - Street 2:SUITE 100
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-4636
Practice Address - Country:US
Practice Address - Phone:404-367-2080
Practice Address - Fax:770-495-3493
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6586225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA65BBCLXMedicare ID - Type Unspecified