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Individual

MR. JOHNNIE VADRON WHEELER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
7825 W BOTTSFORD AVE, GREENFIELD, WI 53220-3325
(773) 668-9715
Mailing address
7825 W BOTTSFORD AVE, GREENFIELD, WI 53220-3325
(773) 668-9715

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
311671-031
WI

Other

Enumeration date
12/26/2009
Last updated
12/26/2009
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