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NPI Code Detail

MEDICARE: LESLIE ALEC MCNEILL LPTA

MEDICARE: LESLIE ALEC MCNEILL LPTA
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
1225200000XPhysical Therapy Assistant635-019WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578776522
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE ALEC MCNEILL LPTA
Provider Business Mailing Address
First Line : 706 SUMMERTON CT
Second Line :
City : SUN PRAIRIE
State : WI
Zip : 53590-3755
Country : US
Telephone Number : 608-825-2105
Fax Number :
Provider Business Practice Location Address
First Line : 41 RICKEL RD
Second Line :
City : SUN PRAIRIE
State : WI
Zip : 53590-1840
Country : US
Telephone Number : 608-825-3242
Fax Number : 608-837-9484
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2007
Last Update Date : 07/08/2007

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