Individual
LILY T SALUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1271 N 6TH ST, MILWAUKEE, WI 53212-3360
(414) 978-9100
Mailing address
1271 N 6TH ST, MILWAUKEE, WI 53212-3360
(414) 978-9100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1490-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41961300
—
WI
Enumeration date
05/24/2006
Last updated
08/05/2024
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