Individual
BO HENRY MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-7040
(414) 955-0175
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-7040
(414) 955-0175
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5799
WI
Other
Enumeration date
07/28/2020
Last updated
06/21/2022
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