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1033538509
LYDIA G TANNEY
GREEN BAY, WI
NPI
1033538509
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2014-04-14
Last Update Date
2014-04-14
Business Address
Mrs. LYDIA G TANNEY LAT
3046 CONESTA DR APT 1
GREEN BAY, WI 54311-4986
Phone number: 920-323-0880
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Mailing Address
Mrs. LYDIA G TANNEY LAT
3046 CONESTA DR APT 1
GREEN BAY, WI 54311-4986
Phone number: 920-323-0880
Copy
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