Individual
MR. DANIEL THOMAS LINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
333 PINE RIDGE BLVD, WAUSAU, WI 54401-4120
(715) 847-2121
(715) 847-2078
Mailing address
333 PINE RIDGE BLVD, WAUSAU, WI 54401-4120
(715) 847-2121
(715) 847-2078
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2704-023
WI
Other
Enumeration date
01/03/2011
Last updated
01/03/2011
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