Individual
MARCIA JOAN VANDENHEUVEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
8633 32ND AVE, KENOSHA, WI 53142-5187
(262) 694-8800
(262) 694-9125
Mailing address
201 MEADOWLARK DR APT 10, BURLINGTON, WI 53105-1767
(920) 595-0177
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10046-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40435200
—
WI
Enumeration date
05/02/2007
Last updated
07/08/2007
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