Individual
MICHELLE HORNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2555 N MLK DR, MILWAUKEE, WI 53212-2709
(414) 372-8080
Mailing address
7439 HARWOOD AVE STE 111, WAUWATOSA, WI 53213-2665
(408) 771-1158
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5092
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/12/2020
Last updated
07/06/2020
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