Individual
MAI TONG THAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6737 W WASHINGTON ST STE 2150, WEST ALLIS, WI 53214-5649
(414) 238-1771
Mailing address
155 N DECHANT RD, BROOKFIELD, WI 53005-3906
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
16929-33
WI
Other
Enumeration date
08/25/2025
Last updated
08/25/2025
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