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Wesley David Theuerkauf

Physical Therapy Assistant in Minocqua, WI. Individual provider (NPI-1).

NPI number1154776144
StatusActive
Last updated in NPPESApr 27, 2016

Details

NPI
1154776144
Entity type
Individual (NPI-1)
Name
Mr. Wesley David Theuerkauf
Sex
Male
Sole proprietor
Yes
Enumeration date
Apr 27, 2016
Last updated
Apr 27, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225200000X Physical Therapy Assistant2236WIYes

Practice location

8067 Brinkland Dr
Minocqua, WI 54548-9236

Phone 715-892-3596

Mailing address

8067 Brinkland Dr
Minocqua, WI 54548-9236

Phone 715-892-3596

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