Individual
MR. JOHNNY WALKER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4523 W MEDFORD AVE, MILWAUKEE, WI 53216-3448
(414) 445-3373
(414) 873-3299
Mailing address
4523 W MEDFORD AVE, MILWAUKEE, WI 53216-3448
(414) 445-3373
(414) 873-9296
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
W4264205140705
WI
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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