Individual
STENNEN N JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2607 W CUSTER AVE, MILWAUKEE, WI 53209-4946
(414) 539-9903
Mailing address
2607 W CUSTER AVE, MILWAUKEE, WI 53209-4946
(414) 539-9903
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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