Provider Demographics
NPI:1740746098
Name:WESELI, KRISTA LEIGH-ANNE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:LEIGH-ANNE
Last Name:WESELI
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 1:903 OLD CAPE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MO
Mailing Address - Zip Code:63755-2260
Mailing Address - Country:US
Mailing Address - Phone:662-425-5174
Mailing Address - Fax:
Practice Address - Street 1:661 W INDEPENDENCE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MO
Practice Address - Zip Code:63755-1882
Practice Address - Country:US
Practice Address - Phone:573-243-9753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-12
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist