Provider Demographics
NPI:1700127677
Name:LESOUSKY, ALLISON (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:LESOUSKY
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 1:7312 MARIA AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-6452
Mailing Address - Country:US
Mailing Address - Phone:502-797-5191
Mailing Address - Fax:
Practice Address - Street 1:7312 MARIA AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-6452
Practice Address - Country:US
Practice Address - Phone:502-797-5191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-02
Last Update Date:2013-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006185225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist