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General NPI Number Information
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NPI Number | 1780352187
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Entity Type | Individual
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Provider Name | MEGAN MARIE LESER PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/31/2021
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 406 W GENESEE ST STE B
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City | FRANKENMUTH
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State | MI
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Zip | 48734-1335
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Country | US
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Telephone | 989-480-8872
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Fax |
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Provider Business Mailing Address
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Address Line | 2925 DARTMOUTH DR
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City | MIDLAND
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State | MI
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Zip | 48642-4629
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Country | US
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Telephone | 989-327-8087
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501020146
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License Number State | MI
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