Individual
TARA MARIE CLEEREMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
200 SOUTH NINTH ST, DEPERE, WI 54115
(920) 338-4145
Mailing address
1913 RIVERSIDE DR UNIT E, GREEN BAY, WI 54313
(920) 217-4334
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1922-19
WI
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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