Provider Demographics
NPI:1952477036
Name:VAN OSS, LEAH M (PTA)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:M
Last Name:VAN OSS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9131 W DIXON ST APT 4
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53214-1361
Mailing Address - Country:US
Mailing Address - Phone:920-850-1688
Mailing Address - Fax:
Practice Address - Street 1:6800 N 76TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-5002
Practice Address - Country:US
Practice Address - Phone:414-353-5000
Practice Address - Fax:414-760-1372
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant