Individual
NICHOLAS THIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
N4231 STATE HIGHWAY 22, SHAWANO, WI 54166-6130
(715) 526-3158
Mailing address
19395 W CAPITOL DR, STE 200, BROOKFIELD, WI 53045-2736
(262) 923-7101
(262) 923-7179
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2536-19
WI
Other
Enumeration date
02/01/2017
Last updated
02/01/2017
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