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1134471279
SHAUNTUN DICKERSON
MILWAUKEE, WI
NPI
1134471279
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
332B00000X Durable Medical Equipment & Medical Supplies
Enumeration Date
2012-10-14
Last Update Date
2012-10-14
Business Address
-- SHAUNTUN DICKERSON
1418 N 27TH ST
MILWAUKEE, WI 53208-2409
Phone number: 414-366-6269
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Mailing Address
-- SHAUNTUN DICKERSON
1418 N 27TH ST
MILWAUKEE, WI 53208-2409
Phone number: 414-366-6269
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