Provider Demographics
NPI:1255436325
Name:LESSILA, ANN KATHLEEN (PT)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:KATHLEEN
Last Name:LESSILA
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:W143N5009 BROOK FALLS DR
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-6987
Mailing Address - Country:US
Mailing Address - Phone:262-781-8352
Mailing Address - Fax:
Practice Address - Street 1:W143N5009 BROOK FALLS DR
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-6987
Practice Address - Country:US
Practice Address - Phone:262-781-8352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4501-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist