Provider Demographics
NPI:1700515160
Name:KAUKER, LEIGH TAYLOR (DPT)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:TAYLOR
Last Name:KAUKER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LEIGH
Other - Middle Name:TAYLOR
Other - Last Name:MOSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:5584 AIRLINE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-9528
Mailing Address - Country:US
Mailing Address - Phone:901-317-7054
Mailing Address - Fax:901-317-7064
Practice Address - Street 1:5584 AIRLINE RD STE 101
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38002-9528
Practice Address - Country:US
Practice Address - Phone:901-317-7054
Practice Address - Fax:901-317-7064
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSCP018460T225100000X
TN14205225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist