Individual
LAMONT TERRANCE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5129 W VIENNA AVE, MILWAUKEE, WI 53216-2312
(414) 803-4976
Mailing address
5129 W VIENNA AVE, MILWAUKEE, WI 53216-2312
(414) 803-4976
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
W452-5387-2415-07
WI
Other
Enumeration date
04/13/2012
Last updated
04/13/2012
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