Individual
JUVONTA LEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6125 N 39TH ST, MILWAUKEE, WI 53209-3509
(262) 281-0216
(855) 810-4227
Mailing address
6125 N 39TH ST, MILWAUKEE, WI 53209-3509
(262) 281-0216
(855) 810-4227
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
0019557
WI
Other
Enumeration date
07/02/2024
Last updated
07/02/2024
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