Individual
MS. LONIQUA KILONDRA DEADWYLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 N 92ND ST, MILWAUKEE, WI 53222-1634
(414) 841-1406
Mailing address
4300 N 92ND ST, MILWAUKEE, WI 53222-1634
(414) 841-1406
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
060728600
GA
Other
Enumeration date
02/25/2022
Last updated
02/25/2022
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