Individual
BRENT MICHAEL TISL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7755 OFFICE PLAZA DR N, WEST DES MOINES, IA 50266-2339
(515) 505-7283
Mailing address
7755 OFFICE PLAZA DR N, WEST DES MOINES, IA 50266-2339
(515) 505-7283
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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