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Individual

MARLON BRANDON MCKAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
901 W WINNEBAGO ST, APT 218, MILWAUKEE, WI 53205-2561
(414) 975-0315
Mailing address
PO BOX 05441, MILWAUKEE, WI 53205-0441
(414) 975-0315

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
310796-031
WI

Other

Enumeration date
04/09/2010
Last updated
04/09/2010
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