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1043569833
NICHOLE SHANNON BLIESNER
MILWAUKEE, WI
NPI
1043569833
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: WI 1561-19)
Enumeration Date
2012-09-07
Last Update Date
2012-09-07
Business Address
Mrs. NICHOLE SHANNON BLIESNER PTA
2448 S 102ND ST STE. 340
MILWAUKEE, WI 53227-2466
Phone number: 414-329-2428
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Mailing Address
Mrs. NICHOLE SHANNON BLIESNER PTA
1434 BLAINE AVE
RACINE, WI 53405-3310
Phone number: 262-681-4802
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