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Individual

JUDITH M RIESCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
601 N 99 ST, SUITE 201, WAUWATOSA, WI 53226
(414) 266-9700
(414) 266-9701
Mailing address
601 N 99 ST, SUITE 201, WAUWATOSA, WI 53226
(414) 266-9700
(414) 266-9701

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
470023
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42931200
WI
Enumeration date
03/28/2006
Last updated
10/16/2019
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