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1114177623
OMAR TATUM
MILWAUKEE, WI
NPI
1114177623
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: WI 1198-19)
Enumeration Date
2008-09-22
Last Update Date
2008-09-22
Business Address
Mr. OMAR TATUM
1435 W BROWN ST APT 3
MILWAUKEE, WI 53205-1227
Phone number: 414-418-8608
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Mailing Address
Mr. OMAR TATUM
1435 W BROWN ST APT 3
MILWAUKEE, WI 53205-1227
Phone number: 414-418-8608
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