TARA HERIDES

WILD ROSE, WI
NPI1053877530
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: WI  2902)
Enumeration Date2019-02-20
Last Update Date2019-02-20
Business Address
TARA HERIDES PTA
425 SUMMIT ST
WILD ROSE, WI 54984-6804
Phone number: 920-622-4342
Mailing Address
TARA HERIDES PTA
N5436 NUTTER ST
WILD ROSE, WI 54984-6752
Phone number: 920-642-0147
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