Individual
MILTON LEGANCHUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
2719 CALUMET AVE, MANITOWOC, WI 54220-5546
(920) 683-1900
Mailing address
1016 N WISCONSIN DR, HOWARDS GROVE, WI 53083-1043
(920) 207-0481
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
680-039
WI
Other
Enumeration date
12/12/2006
Last updated
11/03/2009
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