Individual
KEVIN JAMES TIELENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3021 VOYAGER DR, GREEN BAY, WI 54311-8303
(920) 496-4700
Mailing address
3875 CONARD RD, NEW FRANKEN, WI 54229-9743
(920) 621-0639
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12311-024
WI
Other
Enumeration date
05/22/2013
Last updated
09/28/2022
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