Individual
MALCOLM R DRIESSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1970 S RIDGE RD, GREEN BAY, WI 54304-4125
(920) 430-4888
(920) 430-4889
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(924) 457-2104
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16180-24
WI
225100000X
Physical Therapist
32395
AZ
Other
Enumeration date
11/30/2016
Last updated
02/09/2023
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