Individual
RUBY VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2814 S 108TH ST, WEST ALLIS, WI 53227-3224
(414) 885-3525
Mailing address
2814 S 108TH ST, WEST ALLIS, WI 53227-3224
(414) 885-3525
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP054482
AZ
Other
Enumeration date
07/20/2020
Last updated
07/20/2020
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