Provider Demographics
NPI:1689015471
Name:LEFFLER, MICHAEL L (LPN)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:LEFFLER
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 YOUNGSTOWN POLAND RD
Mailing Address - Street 2:
Mailing Address - City:STRUTHERS
Mailing Address - State:OH
Mailing Address - Zip Code:44471-1103
Mailing Address - Country:US
Mailing Address - Phone:330-318-3078
Mailing Address - Fax:234-855-1072
Practice Address - Street 1:520 YOUNGSTOWN POLAND RD
Practice Address - Street 2:
Practice Address - City:STRUTHERS
Practice Address - State:OH
Practice Address - Zip Code:44471-1103
Practice Address - Country:US
Practice Address - Phone:330-318-3078
Practice Address - Fax:234-855-1072
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2022-03-17
Deactivation Date:2014-02-10
Deactivation Code:
Reactivation Date:2022-03-17
Provider Licenses
StateLicense IDTaxonomies
OHPN.128118-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse