Provider Demographics
NPI:1295108876
Name:MUCHE, LEA (PT, DPT)
Entity type:Individual
Prefix:
First Name:LEA
Middle Name:
Last Name:MUCHE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 SE FLORENCE DR
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8357
Mailing Address - Country:US
Mailing Address - Phone:920-382-8350
Mailing Address - Fax:
Practice Address - Street 1:1885 SE FLORENCE DR
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-8357
Practice Address - Country:US
Practice Address - Phone:920-382-8350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA005211225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist