Individual
TAYLER LEIGH MAULICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1700 MIDWAY RD, MENASHA, WI 54952
(920) 739-0111
Mailing address
1033 S FIDELIS ST, APPLETON, WI 54915-3631
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2681-19
WI
Other
Enumeration date
11/19/2017
Last updated
08/09/2018
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