Individual
LEANA VAN BAALEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2520 FOX RIVER PKWY, WAUKESHA, WI 53189-7747
(262) 446-4842
Mailing address
2520 FOX RIVER PKWY, WAUKESHA, WI 53189-7747
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5449-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750548806
—
WI
Enumeration date
05/16/2008
Last updated
01/25/2013
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