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General NPI Number Information
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NPI Number | 1174364483
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Entity Type | Individual
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Provider Name | ANDREW STEVEN LESKOVAC
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Gender | Male
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 420 UTAH AVE
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City | MC DONALD
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State | OH
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Zip | 44437-1522
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Country | US
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Telephone | 330-978-2928
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Fax |
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Provider Business Mailing Address
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Address Line | 420 UTAH AVE
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City | MC DONALD
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State | OH
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Zip | 44437-1522
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Country | US
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Telephone | 330-978-2928
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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 |
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License Number State |
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