Individual
BREANNA LEIGH RIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(920) 207-9802
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(920) 207-9802
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085003516
IL
363A00000X
Physician Assistant
Primary
2723-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346577368
—
WI
Enumeration date
11/11/2009
Last updated
11/15/2019
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