Male or Other

Mr. Gene R. Niec PTA

Physical Therapy Assistant in Iron Mountain, MI(View on Map)

Full Name

Mr. Gene R Niec PTA

NPI Number

1063688893

NPI Type

Individual Provider

Gender

Male

Enumeration Date

05/01/2008

Specialties

(Taxonomies)

Code

225200000X

Primary Taxonomy

Yes

Licenses

State

Wisconsin

License Number

1152-019

Contact
Information

Purpose

Mailing
Location

Address

W8515 MERRIMAN WEST RD # B
W8515 MERRIMAN WEST RD # B

City

Iron Mountain
Iron Mountain

State

MI
MI

Postal Code

49801-9553
49801-9553

Country

US
US

Telephone Number

(906) 779-1394
(906) 779-1394

Identifiers

Identifier

40440800

Identifier State

WI

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 05/01/2008

Provider Address

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Male or Other

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