Provider Demographics
NPI:1528316171
Name:ZWICK-LOUVTON, LEEAT (PT)
Entity type:Individual
Prefix:MRS
First Name:LEEAT
Middle Name:
Last Name:ZWICK-LOUVTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:LEEAT
Other - Middle Name:
Other - Last Name:ZWICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2209 GLEN AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94709
Mailing Address - Country:US
Mailing Address - Phone:650-245-6188
Mailing Address - Fax:
Practice Address - Street 1:2209 GLEN AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94709
Practice Address - Country:US
Practice Address - Phone:650-245-6188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33376225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist