Individual
MARK A. NIEBUHR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
310 W MAIN STREET, SPARTA, WI 54665-2170
(608) 269-2132
Mailing address
310 W. MAIN STREET, SPARTA, WI 54665-2170
(608) 269-2132
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3134-024
WI
Other
Enumeration date
02/13/2007
Last updated
12/28/2011
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