Individual
EULA M COBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4115A N 24TH PL, MILWAUKEE, WI 53209-6607
(414) 882-1452
Mailing address
4115A N 24TH PL, MILWAUKEE, WI 53209-6607
(414) 882-1452
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
03/03/2022
Last updated
03/03/2022
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