Individual
ZACHARY THIELE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.T.C.
Contact information
Practice address
1892 COUNTY ROAD 51, WATERLOO, IN 46793-9750
(260) 438-1193
Mailing address
1892 COUNTY ROAD 51, WATERLOO, IN 46793-9750
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001964A
IN
Other
Enumeration date
10/27/2015
Last updated
10/27/2015
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