Provider Demographics
NPI:1811029838
Name:LESSILA PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:LESSILA PHYSICAL THERAPY, LLC
Other - Org Name:LESSILA THERAPY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:LESSILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-781-8352
Mailing Address - Street 1:N87W16462 JACOBSON DR
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-2833
Mailing Address - Country:US
Mailing Address - Phone:262-255-1040
Mailing Address - Fax:262-255-4090
Practice Address - Street 1:17700 W CAPITOL DR STOP 6
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045
Practice Address - Country:US
Practice Address - Phone:262-781-3083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4501-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty