IRVIN W TIESKOTTER

LA CROSSE, WI
NPI1528362977
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  1238)
Enumeration Date2010-12-28
Last Update Date2010-12-28
Business Address
-- IRVIN W TIESKOTTER CADCI
212 11TH ST S
LA CROSSE, WI 54601-4116
Phone number: 608-392-9555
Mailing Address
-- IRVIN W TIESKOTTER CADCI
212 11TH ST S
LA CROSSE, WI 54601-4116
Phone number: 608-392-9555
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