Individual
MRS. TIFFANY DENISE GIPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4873 N 24TH ST, MILWAUKEE, WI 53209-5629
(414) 659-3635
Mailing address
4873 N 24TH ST, MILWAUKEE, WI 53209-5629
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
01/16/2020
Last updated
01/16/2020
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