Provider Demographics
NPI:1861780801
Name:LEY, JESSICA FARRIS (PT, DPT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:FARRIS
Last Name:LEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LEA
Other - Last Name:FARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:612 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-2937
Mailing Address - Country:US
Mailing Address - Phone:504-900-1411
Mailing Address - Fax:504-900-1413
Practice Address - Street 1:612 VETERANS MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-2937
Practice Address - Country:US
Practice Address - Phone:504-900-1411
Practice Address - Fax:504-900-1413
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA08438R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist