Individual
MRS. LISA ANN JESKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, RN
Contact information
Practice address
1106 E GENESEE ST, SYRACUSE, NY 13210-1912
(315) 440-4816
Mailing address
30 NORTH ST, MARCELLUS, NY 13108-1230
(315) 440-4816
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
030211
NY
Other
Enumeration date
10/26/2017
Last updated
03/17/2018
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