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1457803850
JOSEPH MICHAEL LIDESTER
MILWAUKEE, WI
NPI
1457803850
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: WI 2578-19)
Enumeration Date
2016-11-01
Last Update Date
2016-11-01
Business Address
-- JOSEPH MICHAEL LIDESTER P.T.A.
9047 W GREENFIELD AVE
MILWAUKEE, WI 53214-2808
Phone number: 414-453-9290
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Mailing Address
-- JOSEPH MICHAEL LIDESTER P.T.A.
3901 HARMONY CT
ZION, IL 60099-9548
Phone number: 262-902-9780
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