Individual
MS. SHUNTELL DOMINIQUE NEWSOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4500 N 71ST ST, MILWAUKEE, WI 53218-5411
(414) 552-0026
(414) 239-8281
Mailing address
4500 N 71ST ST, MILWAUKEE, WI 53218-5411
(414) 552-0026
(414) 239-8281
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
0017334
WI
Other
Enumeration date
04/13/2019
Last updated
04/13/2019
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