Individual
LASAUNDRA WESLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2180 MANGUM RD, BARTLETT, TN 38134-5810
(901) 417-4050
Mailing address
1968 WOOD LANE DR, OLIVE BRANCH, MS 38654-7360
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0000007178
TN
Other
Enumeration date
10/08/2017
Last updated
10/08/2017
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