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Individual

THERESA FALLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4800 S 10TH ST, MILWAUKEE, WI 53221-2412
(414) 744-5370
(414) 744-9052
Mailing address
5956 S KINGAN AVE APT 8, CUDAHY, WI 53110-3448

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
301751-31
WI

Other

Enumeration date
05/12/2016
Last updated
05/12/2016
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