Individual
LILIYA LAKSHTANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
910 E. PARADISE DR., WEST BEND, WI 53024
(262) 338-5933
Mailing address
2423 CARIBOU LN, GRAFTON, WI 53024-9358
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
154245-30
WI
Other
Enumeration date
08/28/2012
Last updated
08/28/2012
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