Provider Demographics
NPI:1528388949
Name:LESACA, JOEL (BSPT)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:
Last Name:LESACA
Suffix:
Gender:M
Credentials:BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 EYE ST NW
Mailing Address - Street 2:BASEMENT # 110
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-3702
Mailing Address - Country:US
Mailing Address - Phone:202-257-1363
Mailing Address - Fax:888-839-9091
Practice Address - Street 1:1712 EYE ST NW
Practice Address - Street 2:BASEMENT # 110
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-3702
Practice Address - Country:US
Practice Address - Phone:202-257-1363
Practice Address - Fax:888-839-9091
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT870635225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist