Individual
MRS. LESLEY WASHATKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 E 5TH AVE, ANTIGO, WI 54409-2710
(715) 623-2351
Mailing address
110 E 5TH AVE, ANTIGO, WI 54409-2710
(715) 623-2351
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/12/2016
Last updated
06/14/2016
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