Provider Demographics
NPI:1871538173
Name:GAITHER, LEAH MICHELLE (ATC)
Entity type:Individual
Prefix:MS
First Name:LEAH
Middle Name:MICHELLE
Last Name:GAITHER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
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Mailing Address - Street 1:2115 COLUMNS DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30504-5956
Mailing Address - Country:US
Mailing Address - Phone:404-374-6273
Mailing Address - Fax:
Practice Address - Street 1:3640 MUNDY MILL RD
Practice Address - Street 2:STE. 102B
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30504-8218
Practice Address - Country:US
Practice Address - Phone:770-287-8821
Practice Address - Fax:770-287-8797
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0012482255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer