Individual
TYLER THIELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
735 3RD ST SW, PERHAM, MN 56573-1152
(605) 271-2690
Mailing address
1105 W RUSSELL ST, SIOUX FALLS, SD 57104-1322
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
MN
Other
Enumeration date
05/25/2022
Last updated
05/25/2022
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