ELISSA BETHMARIE PORATH

MILWAUKEE, WI
NPI1043895287
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: WI  5630)
Enumeration Date2021-03-09
Last Update Date2022-01-03
Business Address
ELISSA BETHMARIE PORATH
945 N 12TH ST
MILWAUKEE, WI 53233-1305
Phone number: 414-219-2000
Mailing Address
ELISSA BETHMARIE PORATH
3301 W FOREST HOME AVE
MILWAUKEE, WI 53215-2843
Phone number: 414-219-2000