Individual
GARRETT B ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY STE 370, MILWAUKEE, WI 53215-3678
(414) 649-7900
Mailing address
2801 W KINNICKINNIC RIVER PKWY STE 370, MILWAUKEE, WI 53215-3678
(414) 649-7900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4816-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100092798
—
WI
Enumeration date
08/06/2019
Last updated
11/19/2021
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