Provider Demographics
NPI:1629708169
Name:LESUEUR, JENNA (DPT)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:LESUEUR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:
Other - Last Name:GALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:4750 LINDLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-2428
Mailing Address - Country:US
Mailing Address - Phone:717-803-3342
Mailing Address - Fax:717-974-8743
Practice Address - Street 1:1952 WADDLE RD STE 103
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-1649
Practice Address - Country:US
Practice Address - Phone:814-413-0731
Practice Address - Fax:814-414-3999
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15869-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist