Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARK R TISDALE, PTA
ActiveMARK R TISDALE, PTA is a Occupational Therapist healthcare provider located in KENOSHA, Wisconsin. NPI 1154626745 is currently active in the NPPES registry. Verify at CMS.
Occupational Therapist · KENOSHA, WI
Registration Details
- NPI Number
- 1154626745
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 13, 2011 (15.539375356172 yrs)
- Last Updated
- Jan 13, 2011
- License
-
897-019 (WI)
Practice Information
- Address
-
10400 75TH STREETKENOSHA, WI, 53142Browse WI providers · Browse ZIP 53142
- Phone
- 2629487045
- Fax
- 2629487331
- Primary Specialty
-
Occupational Therapist
225200000X
Other Occupational Therapist Providers in KENOSHA, WI
| Name | Credential | NPI |
|---|---|---|
| MRS. KIM M PARRETT | PTA | 1679585145 |
| MRS. SHELLEY K ROGERS | P.T.A. | 1548369283 |
| BROOKE OBERMEYER | PTA | 1548318819 |
| CONNIE J BLACKWELL | PTA | 1699823542 |
| STELLA VIKTORIVNA MEINERT | PTA | 1912022286 |
| MS. CHERYL ANN STAEHLER | P.T.A. | 1841411303 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.