Individual
JILL M THEIN-NISSENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 HIGHLAND AVE, COMPLIANCE MAIL CODE-2433, MADISON, WI 53792-0001
(608) 662-0817
Mailing address
600 HIGHLAND AVE, COMPLIANCE MAIL CODE-2433, MADISON, WI 53792-0001
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
4738-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4738-24
PT ORTHOPEDICS
WI
Enumeration date
07/24/2006
Last updated
07/08/2007
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