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NPI Code Detail

MEDICARE: BRIDGETTE LESAR P.T.

MEDICARE: BRIDGETTE LESAR P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist0441NV

General Provider Information

NPI Number : 1063445757
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIDGETTE LESAR P.T.
Provider Business Mailing Address
First Line : 1550 WYOMING CT
Second Line :
City : RENO
State : NV
Zip : 89503-2256
Country : US
Telephone Number : 775-747-6601
Fax Number :
Provider Business Practice Location Address
First Line : 20 N WEST ST
Second Line :
City : FERNLEY
State : NV
Zip : 89408-9799
Country : US
Telephone Number : 775-575-5508
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2006
Last Update Date : 07/08/2007

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Directions to “ BRIDGETTE LESAR P.T.” Practice Location

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