Individual
TIM VAN DER PERREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 PARK AVE, OCONTO, WI 54153-1612
(920) 834-6875
Mailing address
2543 TELLURIDE TRL APT C, GREEN BAY, WI 54313-3972
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1928-154
WI
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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