Individual
MISS RUBY MADISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4128 N 67TH ST, MILWAUKEE, WI 53216-1107
(414) 629-4621
Mailing address
4128 N 67TH ST, MILWAUKEE, WI 53216-1107
(414) 629-4621
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
WI
Other
Enumeration date
08/02/2021
Last updated
08/02/2021
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