Individual
REBECCA SHORTREED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 W MARKET ST STE 110, MEQUON, WI 53092-5053
(262) 388-3666
Mailing address
1975 FARMLANE DR, SLINGER, WI 53086-3003
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
8127-403
WI
Other
Enumeration date
12/15/2025
Last updated
12/15/2025
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