Individual
GEMONTASIA KIRIAQUA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2872 N 59TH ST, MILWAUKEE, WI 53210-1504
(414) 939-5802
Mailing address
2872 N 59TH ST, MILWAUKEE, WI 53210-1504
(414) 939-5802
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
—
—
Other
Enumeration date
11/06/2023
Last updated
12/13/2023
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