Individual
THOMAS VANSISTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
130 2ND ST, NEENAH, WI 54956-2883
(920) 729-3015
(920) 729-3021
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 996-3298
(920) 738-5787
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
37255
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31837700
—
WI
Enumeration date
07/20/2006
Last updated
01/21/2014
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