TANNER J DEIST

PLYMOUTH, WI
NPI1790678944
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: WI  17161-24)
Enumeration Date2025-05-29
Last Update Date2025-08-28
Business Address
TANNER J DEIST PT
2600 KILEY WAY
PLYMOUTH, WI 53073-5020
Phone number: 920-449-7120
Mailing Address
TANNER J DEIST PT
PO BOX 735044
CHICAGO, IL 60673-5044
Phone number: 800-326-2250
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