Individual
MR. KENNY E SAMUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6621 N YUBA ST, MILWAUKEE, WI 53223-5759
(414) 406-1438
(414) 353-5633
Mailing address
PO BOX 090374, MILWAUKEE, WI 53209-0374
(414) 406-1438
(414) 353-5633
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
41488300
WI
Other
Enumeration date
06/12/2009
Last updated
06/12/2009
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