Provider Demographics
NPI:1043389430
Name:NAVITSKIS, LEONARD BENJAMIN (ATC)
Entity Type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:BENJAMIN
Last Name:NAVITSKIS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 E SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1054
Mailing Address - Country:US
Mailing Address - Phone:734-764-0531
Mailing Address - Fax:
Practice Address - Street 1:1200 S STATE ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-2203
Practice Address - Country:US
Practice Address - Phone:734-764-0531
Practice Address - Fax:706-542-9061
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000558174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist