Individual
BECKY J LEASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
505 KELLER AVE S, AMERY, WI 54001
(715) 268-6900
(715) 268-6895
Mailing address
505 KELLER AVE S, AMERY, WI 54001
(715) 268-6900
(715) 268-6895
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6207024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
318L9LE
BCBS OF MN
—
05
—
40322600
—
WI
01
—
6406390
MEDICA INS
—
01
—
HP48014
HEALTH PARTNERS
—
Enumeration date
12/05/2006
Last updated
07/08/2007
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