Individual
ANTHONY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5143 N 68TH ST, MILWAUKEE, WI 53218-3909
(414) 299-9992
Mailing address
5143 N 68TH ST, MILWAUKEE, WI 53218-3909
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000
—
WI
Enumeration date
06/05/2022
Last updated
06/05/2022
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