Provider Demographics
NPI:1134509953
Name:SKIERA, LESLIE (DPT)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:SKIERA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 DILTS RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:MI
Mailing Address - Zip Code:48847-9475
Mailing Address - Country:US
Mailing Address - Phone:989-875-2266
Mailing Address - Fax:989-875-2225
Practice Address - Street 1:203 DILTS RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:MI
Practice Address - Zip Code:48847-9475
Practice Address - Country:US
Practice Address - Phone:989-875-2266
Practice Address - Fax:989-875-2225
Is Sole Proprietor?:No
Enumeration Date:2015-06-06
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017230225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist