Tisha Thelen

NPI #1942329040 in Metamora, Illinois

Provider Information

NPI Number: 1942329040
Entity Type: Individual
Name: Tisha Thelen
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Enumeration Date: Mar 28, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1200 E PARTRIDGE ST
City: Metamora
State: Illinois
ZIP Code: 61548-9619
Phone: (309) 367-4300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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