Individual
MR. LEONARD W WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
456 E BROWN ST APT 206, MILWAUKEE, WI 53212-3846
(414) 736-8708
Mailing address
456 E BROWN ST APT 206, MILWAUKEE, WI 53212-3846
(414) 736-8708
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
12/17/2020
Last updated
12/17/2020
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