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Individual

MIKE LEAHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
822 PARK AVE, BEAVER DAM, WI 53916-2206
(920) 887-7511
(920) 887-0725
Mailing address
822 PARK AVE, BEAVER DAM, WI 53916-2206
(920) 887-7511
(920) 887-0725

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10922-040
WI

Other

Enumeration date
05/17/2013
Last updated
05/17/2013
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