Healthcare Provider Details

I. General information

NPI: 1306864368
Provider Name (Legal Business Name): ANTHONY LESCH PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 ELM ST E
ANNANDALE MN
55302-1109
US

IV. Provider business mailing address

2925 CHICAGO AVE
MINNEAPOLIS MN
55407-1321
US

V. Phone/Fax

Practice location:
  • Phone: 320-274-3744
  • Fax: 320-274-8194
Mailing address:
  • Phone: 612-262-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9482
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: