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Individual

JOHN LESLIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
4111 W MITCHELL ST, MILWAUKEE, WI 53215-1748
(414) 385-8800
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056.012675
IL
225X00000X
Occupational Therapist
Primary
8021
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100272126
WI
Enumeration date
11/14/2018
Last updated
07/23/2024
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