Individual
MARY A WHEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1320 WISCONSIN AVE, RACINE, WI 53403-1978
(262) 687-2222
(262) 687-2495
Mailing address
1320 WISCONSIN AVE, RACINE, WI 53403-1978
(262) 687-2222
(262) 687-2495
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1809
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
704290
—
AZ
Enumeration date
02/07/2006
Last updated
03/29/2018
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