Healthcare Provider Details

I. General information

NPI: 1437225653
Provider Name (Legal Business Name): WILLIAM LEE SESCO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 12/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1527 LEXINGTON AVE
MANSFIELD OH
44907-2631
US

IV. Provider business mailing address

1527 LEXINGTON AVE
MANSFIELD OH
44907-2631
US

V. Phone/Fax

Practice location:
  • Phone: 419-524-3030
  • Fax: 419-756-1142
Mailing address:
  • Phone: 419-524-3030
  • Fax: 419-756-1142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1339
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: