Individual
ISADORE D FORTON LESURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2603 W RAWSON AVE, OAK CREEK, WI 53154-8422
(188) 875-4039
Mailing address
2402 W WELLS ST APT 002, MILWAUKEE, WI 53233-2924
(262) 316-1192
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/28/2025
Last updated
05/28/2025
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