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1326002148
CHARLES N DECLEENE
GREEN BAY, WI
NPI
1326002148
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: WI 10376-24)
Enumeration Date
2006-04-17
Last Update Date
2023-02-03
Business Address
CHARLES N DECLEENE PT
1970 S RIDGE RD
GREEN BAY, WI 54304-4125
Phone number: 920-430-4888
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Mailing Address
CHARLES N DECLEENE PT
PO BOX 22487
GREEN BAY, WI 54305-2487
Phone number: 920-445-7210
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