Provider Demographics
NPI:1144481995
Name:CARTER, LEAH BETH (DPT)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:BETH
Last Name:CARTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 PRINCE JAMES CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3607
Mailing Address - Country:US
Mailing Address - Phone:434-728-2072
Mailing Address - Fax:
Practice Address - Street 1:6161 KEMPSVILLE CIR
Practice Address - Street 2:STE 250
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3932
Practice Address - Country:US
Practice Address - Phone:757-893-9210
Practice Address - Fax:757-893-9247
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305205466225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist