Individual
DOUANGMALA PHRASAVATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 384-2000
Mailing address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 384-2000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
131600-30
WI
Other
Enumeration date
05/17/2010
Last updated
05/17/2010
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