MARK LYDECKER

WAUWATOSA, WI
NPI1669010963
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
Additional Taxonomies2255A2300X Specialist/Technologist Athletic Trainer
Enumeration Date2019-12-17
Last Update Date2019-12-17
Business Address
MARK LYDECKER
8700 W WATERTOWN PLANK RD
WAUWATOSA, WI 53226-3595
Phone number: 414-805-8656
Mailing Address
MARK LYDECKER
8700 W WATERTOWN PLANK RD
WAUWATOSA, WI 53226-3595
Phone number: 414-805-8656
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