Individual
MR. DIMITRY LENIKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1575 W LIEBAU RD, MEQUON, WI 53092-2620
(414) 364-5056
(262) 243-9987
Mailing address
1575 W LIEBAU RD, MEQUON, WI 53092-2620
(414) 364-5056
(262) 243-9987
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41474700
—
WI
Enumeration date
02/02/2007
Last updated
07/09/2007
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