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Individual

RAPHAEL SHERROD JORDAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4051 N 88TH ST, MILWAUKEE, WI 53222-1714
(414) 334-6058
Mailing address
4051 N 88TH ST, MILWAUKEE, WI 53222-1714
(414) 334-6058

Taxonomy

Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
Primary

Other

Enumeration date
03/08/2019
Last updated
03/08/2019
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