Provider Demographics
NPI:1861716656
Name:LEATHERMAN, HANNAH (DPT)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:
Last Name:LEATHERMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:HANNAH
Other - Middle Name:ELIZABETH
Other - Last Name:LEVESQUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:950 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-7840
Mailing Address - Country:US
Mailing Address - Phone:941-404-4567
Mailing Address - Fax:941-373-1219
Practice Address - Street 1:950 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-7840
Practice Address - Country:US
Practice Address - Phone:941-404-4567
Practice Address - Fax:941-373-1219
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0204522251X0800X
FLPT297862251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic