Alice Brooke Leis, PT
Individual provider Active NPI Physical Therapist · Southern Pines, NC
NPI 1831165596 · NPPES record last updated May 20, 2010
Key facts
- NPI
- 1831165596
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 10424 (NC)
- Practice address
- 210 S Bennett St
Southern Pines, NC 28387-5402 - Phone
- (910) 692-8269
- Fax
- (910) 692-8479
- NPI assigned
- Feb 23, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10424 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peak Performance Sports and Physical Therapy, LLC | Physical Therapist | Past |
Accepting new patients |
| Jacksonville Peak Performance Sports & Physical Therapy, L.L.C. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10424 | NC | Yes |
Addresses
Primary practice location
210 S Bennett St
Southern Pines, NC 28387-5402
Mailing address
210 S Bennett St
Southern Pines, NC 28387-5402
Phone (910) 692-8269
Other providers in Southern Pines, NC
- LCS Counseling Services
- Jerome Le-an
- Latoya Leak
- Courtney Lee
- Legacy Healthcare Services, Inc
- Joy Marie Lemieux
- Angela Somers Leonard
- Jenny Lewellen Vaz
- Liberty Anesthesia, PLLC
- Liberty Healthcare Group, LLC
All providers in Southern Pines, NC · Physical Therapist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.