JOSEPH MICHAEL LIDESTER

MILWAUKEE, WI
NPI1457803850
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: WI  2578-19)
Enumeration Date2016-11-01
Last Update Date2016-11-01
Business Address
-- JOSEPH MICHAEL LIDESTER P.T.A.
9047 W GREENFIELD AVE
MILWAUKEE, WI 53214-2808
Phone number: 414-453-9290
Mailing Address
-- JOSEPH MICHAEL LIDESTER P.T.A.
3901 HARMONY CT
ZION, IL 60099-9548
Phone number: 262-902-9780