IDA LEE ROACH

MILWAUKEE, WI
NPI1851543789
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: WI  309438-031)
Enumeration Date2008-10-22
Last Update Date2008-10-23
Business Address
-- IDA LEE ROACH LPN
5319 N 48TH ST
MILWAUKEE, WI 53218-3432
Phone number: 414-915-4926
Mailing Address
-- IDA LEE ROACH LPN
5319 N 48TH ST
MILWAUKEE, WI 53218-3432
Phone number: 414-915-4926
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