Provider Demographics
NPI:1205861630
Name:LEBLANC, JULIE A (PT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:LEBLANC
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:BOWLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:775 LAFAYETTE RD STE 9
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5434
Mailing Address - Country:US
Mailing Address - Phone:603-431-9700
Mailing Address - Fax:603-431-9701
Practice Address - Street 1:187A HIGH ST
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-3125
Practice Address - Country:US
Practice Address - Phone:603-772-0708
Practice Address - Fax:603-431-9701
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2420225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30394221Medicaid