Most Relevant Information
Provider Data
| NPI Number: | 1003435462 |
| Provider Name: | LESLIE ANN MALAVSKY PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 429-19 |
Most Important Dates
| Enumeration Date: | 04/15/2020 |
| Last Updated: | 04/15/2020 |
Provider Practice Location
S74W16775 JANESVILLE RD STE 120
MUSKEGO
WI
531507742
Practice Location Phone/Fax
| Phone: | 4144222191 |
| Fax: | 4144222193 |
Provider Mailing Location
PO BOX 328
MUSKEGO
WI
531500328
Provider Mailing Phone/Fax
| Phone: | 4148038680 |
| Fax: |