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1821873795
COOPER VAUGHN TIETZ
DETROIT LAKES, MN
NPI
1821873795
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: MN 13278)
Enumeration Date
2023-08-29
Last Update Date
2024-09-05
Business Address
COOPER VAUGHN TIETZ DPT
1245 WASHINGTON AVE
DETROIT LAKES, MN 56501-3905
Phone number: 218-846-2000
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Mailing Address
COOPER VAUGHN TIETZ DPT
PO BOX 5074
SIOUX FALLS, SD 57117-5074
Phone number: 605-328-6585
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