Individual
DAVID ANTON GILMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3707 N RICHARDS ST, MILWAUKEE, WI 53212-1673
(414) 386-5859
Mailing address
9529 W BRADLEY RD, MILWAUKEE, WI 53224-2928
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
WI
Other
Enumeration date
09/28/2018
Last updated
09/28/2018
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