Individual
SHAUNTUN DICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1418 N 27TH ST, MILWAUKEE, WI 53208-2409
(414) 366-6269
Mailing address
1418 N 27TH ST, MILWAUKEE, WI 53208-2409
(414) 366-6269
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/14/2012
Last updated
10/14/2012
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