Corissa M Lease

NPI #1437740503 in Black Earth, Wisconsin

Provider Information

NPI Number: 1437740503
Entity Type: Individual
Name: Corissa M Lease
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Feb 1, 2021
Last Updated: Feb 1, 2021

Practice Location

Address: 1218 STATE ST
City: Black Earth
State: Wisconsin
ZIP Code: 53515
Phone: (608) 767-2572

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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