NPI 1457172595

Tyler Nellis, CPED

Practitioner Pedorthist Brussels, WI

Practice location

Address: 9810 County Road D, Brussels, WI 54204-9511
Phone: (920) 445-5515
Mailing address: 9810 Cty Rd D, Brussels, WI 54204

Registered specialties

Pedorthist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224L00000X Licence CPED4584 (WI)

Other Pedorthist providers in Wisconsin →

Registry record

NPI: 1457172595
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Oct 2024
Record last updated: 22 Oct 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.