Individual
SAMANTHA MAE OLIPHANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1319 BEASER AVE, ASHLAND, WI 54806-3614
(715) 682-3468
Mailing address
61498 BECKMAN RD, MARENGO, WI 54855-3448
(715) 413-1528
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2554-19
WI
Other
Enumeration date
11/04/2016
Last updated
11/04/2016
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