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1093479701
ANDRA L NICHOLSON
MILWAUKEE, WI
NPI
1093479701
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172A00000X Driver
(Licence: WI N242-0126-3466-07)
Enumeration Date
2021-10-28
Last Update Date
2023-12-05
Business Address
Mr. ANDRA L NICHOLSON
1724 W CLARKE ST
MILWAUKEE, WI 53206-2030
Phone number: 414-763-9892
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Mailing Address
Mr. ANDRA L NICHOLSON
1724 W CLARKE ST
MILWAUKEE, WI 53206-2030
Phone number: 414-763-9892
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