Individual
DR. BRUCE DANIEL LECKEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 683-5278
(920) 686-9674
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
1675-321
WI
207ZD0900X
Dermatopathology (Pathology) Physician
1675-321
WI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
1675-321
WI
Other
Enumeration date
03/28/2016
Last updated
07/26/2022
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