Individual
AMY R FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-5000
(414) 805-7348
Mailing address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-5000
(414) 805-7348
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
56633
WI
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
56633
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100034107
—
WI
Enumeration date
04/04/2010
Last updated
09/01/2022
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