Individual
DOMINIC THIELEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
106 W WASHINGTON ST STE 2, JEFFERSON, IA 50129-1920
(515) 386-4192
Mailing address
1215 DUFF AVE, AMES, IA 50010-5469
(515) 239-4400
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
083240
IA
225100000X
Physical Therapist
PT-4458
ID
Other
Enumeration date
06/13/2016
Last updated
12/16/2021
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