Individual
SHANQUANET SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4229 W LUSCHER AVE, MILWAUKEE, WI 53209-5240
(404) 956-9691
Mailing address
4229 W LUSCHER AVE, MILWAUKEE, WI 53209-5240
(404) 956-9691
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
342000000X
Transportation Network Company
—
—
Other
Enumeration date
04/12/2024
Last updated
04/12/2024
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