Provider Demographics
NPI:1861261778
Name:SLESK, JOSH (DPT)
Entity type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:SLESK
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 E BASELINE RD APT 2101
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2685
Mailing Address - Country:US
Mailing Address - Phone:360-389-0648
Mailing Address - Fax:
Practice Address - Street 1:3225 E BASELINE RD APT 2101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2685
Practice Address - Country:US
Practice Address - Phone:360-389-0648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-033365225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist