Individual
AMY MCGRAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 W PARADISE DR, WEST BEND, WI 53095-9795
(262) 334-3451
Mailing address
1190 E PARADISE DR, WEST BEND, WI 53095-5444
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4540
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25000
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
10/20/2006
Last updated
07/08/2007
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