MITCHELL EDWARD MLEZIVA

MEQUON, WI
NPI1104315050
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WI  1720-39)
Enumeration Date2018-05-07
Last Update Date2018-05-07
Business Address
MITCHELL EDWARD MLEZIVA
12800 N LAKE SHORE DR
MEQUON, WI 53097-2418
Phone number: 262-243-4414
Mailing Address
MITCHELL EDWARD MLEZIVA
509 HILLCREST CT
SAUKVILLE, WI 53080-2560
Phone number: 920-536-0647
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