Wisconsin
Department of Safety and Professional Services
Provencher, Timothy J
Physical Therapist
License number
4146-24
Date granted
09/25/1991
Date expires
02/28/2015
Class
Physical Therapist
Status
Active
wisconsinlicensing.org
ID 12804591
LAST UPDATED 2024-02-20 00:28:55 UTC
LAST UPDATED 2024-02-20 00:28:55 UTC
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