Individual
JEFFREY S THIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
430 E DIVISION ST, FOND DU LAC, WI 54935
(920) 926-5390
Mailing address
430 E DIVISION ST, FOND DU LAC, WI 54935
(920) 926-5390
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3639024
WI
Other
Enumeration date
06/09/2006
Last updated
08/16/2007
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