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Individual

BAILEY LEESON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC, LAT

Contact information

Practice address
10550 N STRATFORD PL, MEQUON, WI 53092-5553
(414) 719-0244
Mailing address
10550 N STRATFORD PL, MEQUON, WI 53092-5553
(414) 719-0244

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1520-39
WI

Other

Enumeration date
01/20/2015
Last updated
01/20/2015
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