Provider Demographics
NPI:1598905374
Name:ALLISON, LESLEY REITTINGER (PT)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:REITTINGER
Last Name:ALLISON
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 1:343 BROCKELMAN RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:MA
Mailing Address - Zip Code:01523-2307
Mailing Address - Country:US
Mailing Address - Phone:410-598-6891
Mailing Address - Fax:
Practice Address - Street 1:343 BROCKELMAN RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:MA
Practice Address - Zip Code:01523-2307
Practice Address - Country:US
Practice Address - Phone:410-598-6891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18109225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist