Individual
AMBER LONDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.R., P.T.A.
Contact information
Practice address
275 REGENCY CT, SUITE 200, BROOKFIELD, WI 53045-6168
(262) 798-9650
(262) 798-9652
Mailing address
275 REGENCY CT, SUITE 200, BROOKFIELD, WI 53045-6168
(262) 798-9650
(262) 798-9652
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
06002835A
IN
225200000X
Physical Therapy Assistant
267-019
WI
225X00000X
Occupational Therapist
31004485A
IN
225X00000X
Occupational Therapist
Primary
4466-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06002835A
PTA INDIANA LICENSE
IN
01
—
267-019
PTA STATE LICENSE
WI
01
—
31004485A
OCCUPATIONAL THERAPIST INDIANA LICENSE
IN
01
—
4466-026
OCCUPATIONAL THERAPIST STATE LICENSE/PTA STATE LICENSE
WI
Enumeration date
09/23/2008
Last updated
09/23/2008
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