-- TRACY BANTLEON --
Individual Provider (NPI-1)
Active
Physical Therapy Assistant
Provider Information
- NPI Number
1811301591- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 3129 MICHIGAN AVE, SHEBOYGAN, WI, 530813062
- Phone
- (920) 458-1155
- Fax
- (920) 458-1173
Specialties & Taxonomies
Physical Therapy Assistant
Primary License: WI #1999-19
All Addresses
MAILING
3129 MICHIGAN AVE
SHEBOYGAN, WI, 530813062