Individual
MRS. LESLIE M CANNESTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
W261S8347 FAULKNER RD, MUKWONAGO, WI 53149-8519
(414) 839-3763
Mailing address
7823 W VERONA CT, MILWAUKEE, WI 53219-3861
(414) 727-5403
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3147-026
WI
Other
Enumeration date
05/09/2008
Last updated
12/26/2021
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