Individual
LESLIE DIANE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT017702
OH
225100000X
Physical Therapist
Primary
PT5223
MS
2251X0800X
Orthopedic Physical Therapist
PT017702
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0317629
—
OH
Enumeration date
07/16/2012
Last updated
03/25/2025
Update your record
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