Individual
MR. TIMOTHY RICHARD THEISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
250 GAUGER ST NE, HUTCHINSON, MN 55350-1707
(320) 583-0422
Mailing address
250 GAUGER ST NE, HUTCHINSON, MN 55350-1707
(320) 583-0422
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A249
MN
Other
Enumeration date
08/17/2015
Last updated
08/17/2015
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