Individual
MR. JOSEPH E THEISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, ATC
Contact information
Practice address
2323 N CASALOMA DR, APPLETON, WI 54913-8284
(920) 730-8833
Mailing address
2323 N CASALOMA DR, APPLETON, WI 54913-8284
(920) 730-8833
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2133-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40166800
—
WI
Enumeration date
04/16/2007
Last updated
10/31/2012
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