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1407917883
MILTON LEGANCHUK
MANITOWOC, WI
NPI
1407917883
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WI 680-039)
Enumeration Date
2006-12-12
Last Update Date
2009-11-03
Business Address
-- MILTON LEGANCHUK LAT
2719 CALUMET AVE
MANITOWOC, WI 54220-5546
Phone number: 920-683-1900
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Mailing Address
-- MILTON LEGANCHUK LAT
1016 N WISCONSIN DR
HOWARDS GROVE, WI 53083-1043
Phone number: 920-207-0481
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