Graduated: 1975
NPI: 1548267768
Practice Locations (2)
INDIANHEAD MEDICAL CENTER SHELL LAKE, INC.
24670 STATE RD, 70 SUITE 100
SIREN, WI 548724419
7153492910
ADVANTAGE PHYSICAL THERAPY AND SPORTS REHAB, LLC
112 ASH ST, SUITE A
SPOONER, WI 548011487
7156353979
Source: CMS National Downloadable File, September 2026.