Individual
THERESA L MADISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3927 N 37TH ST, MILWAUKEE, WI 53216-2510
(414) 875-8042
Mailing address
3927 N 37TH ST, MILWAUKEE, WI 53216-2510
(414) 875-8042
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
33521-031
WI
Other
Enumeration date
04/15/2009
Last updated
04/15/2009
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