Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Daniel Tellijohn, CP

Individual provider Prosthetist · NPI 1407716533

Daniel Tellijohn, CP is an Undefined Non-Physician Type (Specify) in Wausau, Wisconsin. Qualified in 2004, 22 years ago. Licensed in Wisconsin.

Years since qualifying
22
Licensed in
WI
In the registry since
2025

Practice location Address checks out

1700 Stewart Ave Ste 300
Wausau, WI 54401-5345
Phone: (715) 679-3776
Fax: (715) 841-0087
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prosthetist (primary) Taxonomy 224P00000X · Licence CP003277 (WI)

Record details

NPI number1407716533
Entity typeIndividual (Type 1)
GenderMale
Credentials CP
Sole proprietorNo
NPI enumeratedNovember 12, 2025
Last updated in NPPESNovember 12, 2025
Certification dateNovember 12, 2025
Mailing address1700 Stewart Ave Ste 300, Wausau, WI 54401-5345

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUNDEFINED NON-PHYSICIAN TYPE (SPECIFY)
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Wausau