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1457649352
ANTHONY JACK ETTMAYER
PORT WASHINGTON, WI
NPI
1457649352
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: WI 11821-024)
Enumeration Date
2011-07-13
Last Update Date
2011-07-13
Business Address
Mr. ANTHONY JACK ETTMAYER PT
1119 N WISCONSIN ST
PORT WASHINGTON, WI 53074-1209
Phone number: 262-284-5892
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Mailing Address
Mr. ANTHONY JACK ETTMAYER PT
1119 N WISCONSIN ST
PORT WASHINGTON, WI 53074-1209
Phone number: 262-284-5892
Copy
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