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Individual

CONNOR LEICHTLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAT, ATC

Contact information

Practice address
930 EVASHEVSKI DR, IOWA CITY, IA 52242-1186
(262) 355-6241
Mailing address
603 CABRINI CIR, WEST BEND, WI 53095-4623
(262) 355-6241

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
087833
IA

Other

Enumeration date
04/01/2019
Last updated
04/01/2019
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