Individual
MR. NICHOLAS LEIMBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
11 INTERLAKEN RD, LAKEVILLE, CT 06039-2141
(401) 569-5102
Mailing address
PO BOX 602, LAKEVILLE, CT 06039-0602
(401) 569-5102
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
998
CT
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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