Individual
LARRY DAVION SEPHUS SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
5838 N 117TH ST, MILWAUKEE, WI 53225-2208
(414) 514-4555
Mailing address
5838 N 117TH ST, MILWAUKEE, WI 53225-2208
(414) 514-4555
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
04/22/2025
Last updated
04/22/2025
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