Individual
DAVE SPENCER MAYUELA TABOADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
403 N GLENDALE AVE APT 103, TOMAH, WI 54660-1322
(608) 372-3971
Mailing address
403 N GLENDALE AVE APT 103, TOMAH, WI 54660-1322
(608) 372-3971
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05007580A
IN
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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