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General NPI Number Information
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NPI Number | 1043389430
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Entity Type | Individual
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Provider Name | LEONARD BENJAMIN NAVITSKIS ATC
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Gender | Male
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 1200 S STATE ST
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City | ANN ARBOR
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State | MI
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Zip | 48109-2203
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Country | US
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Telephone | 734-764-0531
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Fax | 706-542-9061
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Provider Business Mailing Address
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Address Line | 134 E SUMMIT ST
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City | CHELSEA
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State | MI
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Zip | 48118-1054
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Country | US
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Telephone | 734-764-0531
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 000558
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License Number State | GA
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