Provider Demographics
NPI:1174797989
Name:MACLEOD, TORAN DRUE (PT)
Entity type:Individual
Prefix:
First Name:TORAN
Middle Name:DRUE
Last Name:MACLEOD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:TORAN
Other - Middle Name:DRUE
Other - Last Name:FURCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1015 BAYLOR DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-3129
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:63 E DELAWARE AVE
Practice Address - Street 2:053 MCKINLY LAB
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19716-3798
Practice Address - Country:US
Practice Address - Phone:302-831-8420
Practice Address - Fax:302-831-4468
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0002337208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation