Individual
VISHALLA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2533 W AUER AVE, MILWAUKEE, WI 53206-1223
(414) 243-9434
Mailing address
2533 W AUER AVE, MILWAUKEE, WI 53206-1223
(414) 243-9434
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
D120-8777-7955-01
WI
172V00000X
Community Health Worker
Primary
D120-8777-7955-01
WI
172V00000X
Community Health Worker
—
—
Other
Enumeration date
11/14/2009
Last updated
11/14/2009
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