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Individual

MR. VICTOR ADEGOKE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8220 W LYNMAR TER, MILWAUKEE, WI 53222-1937
(414) 460-6734
(414) 616-3344
Mailing address
8220 W LYNMAR TER, MILWAUKEE, WI 53222-1937
(414) 460-6734
(414) 616-3344

Taxonomy

Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
Primary
41451800
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41451800
WI
Enumeration date
12/26/2007
Last updated
12/26/2007
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