Individual
MR. JEROME ROBERT ZIEMENDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
6263 N GREEN BAY AVE, MILWAUKEE, WI 53209-3823
(414) 351-0543
Mailing address
10519 W SUNSET WOODS LN, MEQUON, WI 53097-2907
(262) 242-3445
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
726-19
WI
Other
Enumeration date
12/30/2012
Last updated
12/30/2012
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