Individual
NICCOLE RIETVELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8800 W LINCOLN AVE, WEST ALLIS, WI 53227-2400
(414) 541-1118
Mailing address
6361 S 27TH ST LOT 24, FRANKLIN, WI 53132-9410
(414) 531-5176
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2652-19
WI
Other
Enumeration date
11/19/2017
Last updated
11/19/2017
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