Individual
JILL S TIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
235 E STATE ST, SAINT CROIX FALLS, WI 54024-4117
(715) 483-3221
(715) 483-0507
Mailing address
235 E STATE ST, SAINT CROIX FALLS, WI 54024-4117
(715) 483-3221
(715) 483-0507
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
54198
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336302595
—
WI
Enumeration date
07/08/2008
Last updated
02/02/2021
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