Individual
DR. TYLER PENSIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
W5675 CTY HWY B, SHAWANO, WI 54166
(715) 526-6158
Mailing address
N4791 CAPITOL DR, SHAWANO, WI 54166-6102
(715) 304-9645
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5446-12
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5446-12
STATE LICENSE NUMBER
WI
Enumeration date
04/04/2019
Last updated
04/04/2019
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