Individual
DEVONTE LEGGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6558 N BEALE ST # SY, MILWAUKEE, WI 53224-5208
(414) 739-5833
Mailing address
6558 N BEALE ST, MILWAUKEE, WI 53224-5208
(414) 749-5833
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
L2401639230303
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H070127
DONT HAVE ONE
WI
Enumeration date
09/08/2021
Last updated
08/12/2022
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