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NPI Code Detail

MEDICARE: LEAH M VAN OSS PTA

MEDICARE: LEAH M VAN OSS PTA
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 Assistant

General Provider Information

NPI Number : 1952477036
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH M VAN OSS PTA
Provider Business Mailing Address
First Line : 9131 W DIXON ST APT 4
Second Line :
City : MILWAUKEE
State : WI
Zip : 53214-1361
Country : US
Telephone Number : 920-850-1688
Fax Number :
Provider Business Practice Location Address
First Line : 6800 N 76TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53223-5002
Country : US
Telephone Number : 414-353-5000
Fax Number : 414-760-1372
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2006
Last Update Date : 07/08/2007

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Directions to “ LEAH M VAN OSS PTA” Practice Location

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