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Individual

MR. GENE R NIEC

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
W8515 MERRIMAN WEST RD # B, IRON MOUNTAIN, MI 49801-9553
(906) 779-1394
Mailing address
W8515 MERRIMAN WEST RD # B, IRON MOUNTAIN, MI 49801-9553
(906) 779-1394

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1152-019
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40440800
WI
Enumeration date
05/01/2008
Last updated
05/01/2008
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