Individual
AMANDA BORCHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
8060 N 60TH ST, BROWN DEER, WI 53223-3538
(414) 371-6737
Mailing address
8060 N 60TH ST, BROWN DEER, WI 53223-3538
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1358
WI
Other
Enumeration date
12/08/2014
Last updated
12/08/2014
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