Provider Demographics
NPI:1033217070
Name:LESESKY, BRIAN MICHAEL (PT)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:MICHAEL
Last Name:LESESKY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6406 MCCRIMMON PKWY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8144
Mailing Address - Country:US
Mailing Address - Phone:919-467-4558
Mailing Address - Fax:919-467-4594
Practice Address - Street 1:6406 MCCRIMMON PKWY
Practice Address - Street 2:SUITE 250
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-8144
Practice Address - Country:US
Practice Address - Phone:919-467-4558
Practice Address - Fax:919-467-4594
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
NC10761225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0010761OtherLICENSE #