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1689957755
SUSAN ELAINE THALLER
MILWAUKEE, WI
NPI
1689957755
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: WI 4582-033)
Enumeration Date
2011-09-24
Last Update Date
2013-09-25
Business Address
-- SUSAN ELAINE THALLER
2320 W BURLEIGH ST
MILWAUKEE, WI 53206-1751
Phone number: 414-431-9563
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Mailing Address
-- SUSAN ELAINE THALLER
2320 W BURLEIGH ST
MILWAUKEE, WI 53206-1751
Phone number:
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