Individual
RENAE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5607 W SILVER SPRING DR, MILWAUKEE, WI 53218-3264
(414) 750-2253
Mailing address
5607 W SILVER SPRING DR, MILWAUKEE, WI 53218-3264
(414) 750-2253
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
WI
Other
Enumeration date
07/09/2026
Last updated
07/09/2026
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