Provider Demographics
NPI:1316414212
Name:LESKE, JOHN AARON II
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:AARON
Last Name:LESKE
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2044 S 12TH ST W
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-4816
Mailing Address - Country:US
Mailing Address - Phone:406-203-2973
Mailing Address - Fax:
Practice Address - Street 1:2044 S 12TH ST W
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-4816
Practice Address - Country:US
Practice Address - Phone:406-203-2973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-29
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT2255A2300XOtherATHLETIC TRAINING