Individual
PORSHA BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4054 N 69TH ST, MILWAUKEE, WI 53216-1121
(262) 893-2451
Mailing address
4054 N 69TH ST, MILWAUKEE, WI 53216-1121
(262) 893-2451
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
05/23/2022
Last updated
10/12/2022
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