OMAR TATUM

MILWAUKEE, WI
NPI1114177623
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: WI  1198-19)
Enumeration Date2008-09-22
Last Update Date2008-09-22
Business Address
Mr. OMAR TATUM
1435 W BROWN ST APT 3
MILWAUKEE, WI 53205-1227
Phone number: 414-418-8608
Mailing Address
Mr. OMAR TATUM
1435 W BROWN ST APT 3
MILWAUKEE, WI 53205-1227
Phone number: 414-418-8608