Provider Demographics
NPI:1053143909
Name:LEONARD, GEMMA (DPT)
Entity type:Individual
Prefix:
First Name:GEMMA
Middle Name:
Last Name:LEONARD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44484 POTTER TER
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-7155
Mailing Address - Country:US
Mailing Address - Phone:571-458-0553
Mailing Address - Fax:
Practice Address - Street 1:11800 SUNRISE VALLEY DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-5300
Practice Address - Country:US
Practice Address - Phone:703-709-1118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist