Provider Demographics
NPI:1063445757
Name:LESAR, BRIDGETTE (PT)
Entity Type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:
Last Name:LESAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 WYOMING CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-2256
Mailing Address - Country:US
Mailing Address - Phone:775-747-6601
Mailing Address - Fax:
Practice Address - Street 1:20 N WEST ST
Practice Address - Street 2:
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408-9799
Practice Address - Country:US
Practice Address - Phone:775-575-5508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0441225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist