Kevin Alan Leiseberg, MS, PT

NPI #1093827685 in Marengo, Illinois

Provider Information

NPI Number: 1093827685
Entity Type: Individual
Name: Kevin Alan Leiseberg, MS, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: MS, PT
Enumeration Date: Aug 31, 2006
Last Updated: Apr 21, 2016

Practice Location

Address: 300 S STATE ST
City: Marengo
State: Illinois
ZIP Code: 60152-3532
Phone: (815) 568-4550

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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