TANIELLE SUMMERILL

WAUWATOSA, WI
NPI1447351564
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: WI  990-019)
Additional Taxonomies225200000X Physical Therapy Assistant
(Licence: ID  PTA-300)
Enumeration Date2006-09-25
Last Update Date2007-07-08
Business Address
-- TANIELLE SUMMERILL PTA
2626 N WAUWATOSA AVE
WAUWATOSA, WI 53213-1137
Phone number: 414-774-7794
Mailing Address
-- TANIELLE SUMMERILL PTA
242 N 111TH ST
WAUWATOSA, WI 53226-4111
Phone number: 414-476-2304