Individual
LIAN H MLEZIVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
W180N8085 TOWN HALL RD, MENOMONEE FALLS, WI 53051-3518
(262) 257-5100
(262) 253-7081
Mailing address
W180N8085 TOWN HALL RD, MENOMONEE FALLS, WI 53051-3518
(262) 257-5100
(262) 253-7081
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4131-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588189229
—
WI
Enumeration date
08/03/2017
Last updated
06/03/2021
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