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Individual

BRIANA LYNN TECKENBURG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
459 E 1ST ST, FOND DU LAC, WI 54935-4505
(920) 929-3500
Mailing address
1336 STONE RIDGE RD APT 58, WAUPACA, WI 54981-8639
(641) 849-0516

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3107-19
WI
225200000X
Physical Therapy Assistant

Other

Enumeration date
11/11/2020
Last updated
04/28/2022
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