Individual
MR. EVERETT TYSDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
535 HOSPITAL RD, NEW RICHMOND, WI 54017-1449
(715) 243-2755
Mailing address
1621 160TH AVE, NEW RICHMOND, WI 54017-6709
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1527-024
WI
Other
Enumeration date
01/24/2007
Last updated
07/08/2007
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