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1538590757
MICAH RYAN TIEGS
ROCKFORD, IL
NPI
1538590757
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085.004941)
Enumeration Date
2013-12-13
Last Update Date
2019-03-19
Business Address
Mr. MICAH RYAN TIEGS PA-C
1200 W STATE ST
ROCKFORD, IL 61102-2112
Phone number: 815-490-1600
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Mailing Address
Mr. MICAH RYAN TIEGS PA-C
1200 W STATE ST
ROCKFORD, IL 61102-2112
Phone number: 815-490-1600
Copy
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