Individual
THERESA LEESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
125 BRIDGE ST, THERESA, NY 13691-2204
(315) 628-4432
Mailing address
125 BRIDGE ST, THERESA, NY 13691-2204
(315) 628-4432
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
320071
NY
Other
Enumeration date
03/27/2012
Last updated
03/27/2012
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