Individual
KYLIE VAN LANEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
960 S RAPIDS RD, MANITOWOC, WI 54220-4146
(920) 684-1144
(920) 482-0651
Mailing address
960 S RAPIDS RD, MANITOWOC, WI 54220-4146
(920) 684-1144
(920) 482-0651
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1715-19
WI
Other
Enumeration date
11/01/2010
Last updated
11/01/2010
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