Provider Demographics
NPI:1063157212
Name:MCGHEE, LEESA
Entity type:Individual
Prefix:
First Name:LEESA
Middle Name:
Last Name:MCGHEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 W CLARKE ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53206-2030
Mailing Address - Country:US
Mailing Address - Phone:414-460-9246
Mailing Address - Fax:
Practice Address - Street 1:1700 W CLARKE ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53206-2030
Practice Address - Country:US
Practice Address - Phone:414-460-9246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist