Individual
BENJAMIN JOSEPH LICKTEIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2910 ENLOE ST STE 101, HUDSON, WI 54016-4539
(952) 207-2186
Mailing address
2910 ENLOE ST STE 101, HUDSON, WI 54016-4539
(715) 690-2910
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6094
WI
111N00000X
Chiropractor
6790
MN
Other
Enumeration date
03/10/2021
Last updated
08/08/2024
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