Individual
MRS. VERONICA LEQUIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-5640
Mailing address
PO BOX 73044, CHICAGO, IL 60673-7044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3547-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100046478
—
WI
Enumeration date
06/22/2015
Last updated
07/29/2024
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