MICAH RYAN TIEGS

ROCKFORD, IL
NPI1538590757
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: IL  085.004941)
Enumeration Date2013-12-13
Last Update Date2019-03-19
Business Address
Mr. MICAH RYAN TIEGS PA-C
1200 W STATE ST
ROCKFORD, IL 61102-2112
Phone number: 815-490-1600
Mailing Address
Mr. MICAH RYAN TIEGS PA-C
1200 W STATE ST
ROCKFORD, IL 61102-2112
Phone number: 815-490-1600