Individual
S TEAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4230 N OAKLAND AVE # 240, MILWAUKEE, WI 53211-2042
(414) 202-2646
Mailing address
4230 N OAKLAND AVE # 240, MILWAUKEE, WI 53211-2042
(414) 202-2646
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
11/10/2022
Last updated
11/10/2022
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