Individual
AMANDA LEE HAUGRUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1850 11TH ST, FENNIMORE, WI 53809-1612
(608) 822-6100
Mailing address
1850 11TH ST, FENNIMORE, WI 53809-1612
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1777-019
WI
Other
Enumeration date
09/12/2011
Last updated
09/12/2011
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