Individual
JAVIER MORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2901 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4329
(414) 649-3323
Mailing address
2901 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4329
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
WI
Other
Enumeration date
03/23/2021
Last updated
03/24/2021
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