Doctor Name: | BRADLY TIEHES |
NPI Number: | 1124487558 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT |
License Number: | 2016003535 |
Business Practice Address: | 217 E 5th St Eureka, MO - 630251223 |
Business Phone Number: | 6365490151 |
Business Fax Number: | 6365490152 |
Mailing Address: | 625 Enterprise Dr, OAK BROOK |
State: | IL |
Postal Code: | 605238813 |
Phone Number: | 6305751980 |
Fax Number: | 6309285080 |
NPI Enumeration Date: | 02/12/2016 |
NPI Last Update Date: | 02/12/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 2016003535 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |