Individual
MR. VINCENT MARLON NASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4502 W MELVINA ST, MILWAUKEE, WI 53216-2437
(414) 305-9407
Mailing address
4502 W MELVINA ST, MILWAUKEE, WI 53216-2437
(414) 305-9407
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100037116
—
WI
Enumeration date
06/02/2014
Last updated
06/02/2014
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