Individual
MRS. TINA LOUISE MENTCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1451 CLEVELAND AVE, WAUKESHA, WI 53186-3876
(262) 547-2123
Mailing address
1451 CLEVELAND AVE, WAUKESHA, WI 53186-3876
(262) 547-2123
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
945-019
WI
Other
Enumeration date
11/05/2007
Last updated
11/05/2007
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