Individual
TANYA A WILBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1915 W FAIRMOUNT AVE, MILWAUKEE, WI 53209
(414) 795-9731
Mailing address
PO BOX 340324, MILWAUKEE, WI 53234-0324
(414) 795-9731
Taxonomy
Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
Primary
W4168017666106
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46-4216712
—
WI
Enumeration date
04/03/2020
Last updated
04/03/2020
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