Organization
MOM2MOM PNCC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATASIA SHAW (OWNER)
(414) 748-7919
Entity
Organization
Contact information
Practice address
7300 W DEAN RD APT 1160N, MILWAUKEE, WI 53223-0023
(414) 748-7919
Mailing address
7300 W DEAN RD APT 1160N, MILWAUKEE, WI 53223-0023
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
10/07/2022
Last updated
12/17/2024
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