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Individual

MR. DARRYL LAMONT HARRIS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6090 N 35TH ST STE 2A, MILWAUKEE, WI 53209-3602
(414) 204-9123
Mailing address
6090 N 35TH ST STE 2A, MILWAUKEE, WI 53209-3602
(414) 204-9123

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
H620-1728-7164-09
DRIVERS LICENSE
WI
Enumeration date
08/23/2021
Last updated
07/21/2022
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