Individual
MR. TYLER RICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1123 S CLEVELAND ST, SHAWANO, WI 54166-3507
(715) 526-9691
Mailing address
1123 S CLEVELAND ST, SHAWANO, WI 54166-3507
(715) 526-9691
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
185433-30
WI
Other
Enumeration date
01/03/2012
Last updated
01/27/2012
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