Individual
TYLER LOESL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
240 S ROLLAND RD, BROOKFIELD, WI 53005-6320
(262) 501-9479
Mailing address
240 S ROLLAND RD, BROOKFIELD, WI 53005-6320
(262) 501-9479
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2072-19
WI
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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