Individual
MR. RAY ROSS PUPPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.N.
Contact information
Practice address
1705 E MARION ST, SHOREWOOD, WI 53211-1522
(414) 687-5500
Mailing address
1705 E MARION ST, SHOREWOOD, WI 53211-1522
(414) 687-5500
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
314422
WI
Other
Enumeration date
03/14/2018
Last updated
03/14/2018
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