Shade Medical and Creative Tattoo LLC

NPI #1548820731 in Madison, Wisconsin

Provider Information

NPI Number
1548820731
Entity Type
Organization
Organization Name
Shade Medical and Creative Tattoo LLC
Primary Specialty
Specialist/Technologist, Other - Art, Medical
Enumeration Date
Jun 19, 2019
Last Updated
Jun 19, 2019

Practice Location

Address
3230 UNIVERSITY AVE STE 12
ZIP Code
53705-3540
Phone
(608) 571-2617

Authorized Official

Name
ALISSA CHRISTINE WATERS
Title
OWNER/TATTOOIST
Phone
(608) 770-5682

Specialties & Taxonomy Codes

Specialty
Specialist/Technologist, Other - Art, MedicalArt, Medical

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