Individual
FAITH MARIE VANDENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
N4065 COUNTY ROAD U, DE PERE, WI 54115-8801
(920) 422-1193
Mailing address
N4065 COUNTY ROAD U, DE PERE, WI 54115-8801
(920) 422-1193
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
722237
WI
Other
Enumeration date
06/02/2021
Last updated
06/02/2021
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