Whalio Doctors

NPI 1659149839

Jackson Lab Services LLC

Organisation Point of Service Milwaukee, WI

Practice location

Address
2872 N 59th St, Milwaukee, WI 53210-1504
Phone
(414) 939-5802
Mailing address
5721 N 90th St, Milwaukee, WI 53225-2833

Authorised official

Name
Gemontasia Jackson
Title
Director
Phone
(414) 939-5802

Registered specialties

Point of Service Primary
Managed Care Organizations Taxonomy 305S00000X

Registry record

NPI
1659149839
Entity type
Organization
NPI issued
18 Dec 2023
Record last updated
18 Jul 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.