Individual
MISS DIANE ELIZABETH ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
316 N MILWAUKEE ST STE 208, MILWAUKEE, WI 53202-5803
(414) 615-0665
(414) 615-0667
Mailing address
17085 W NATIONAL AVE, NEW BERLIN, WI 53151-5523
(262) 617-7748
(262) 786-1087
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1329-019
WI
Other
Enumeration date
07/23/2007
Last updated
05/06/2009
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