Individual
LAURA D SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4418 W CONGRESS ST, MILWAUKEE, WI 53218-5261
(414) 368-7657
Mailing address
4418 W CONGRESS ST # 53, MILWAUKEE, WI 53218-5261
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
S52305249055009
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4143687657
—
WI
01
—
S5035249055009
NON-EMERGENCY MEDICAL TRANSPORTATION
WI
Enumeration date
12/21/2021
Last updated
12/21/2021
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