Individual
MS. SARAH ANN DETTWILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, PTA
Contact information
Practice address
1400 WASHINGTON ST, SUITE 3, TWO RIVERS, WI 54241-3043
(920) 553-8993
(920) 553-8990
Mailing address
1400 WASHINGTON ST, SUITE 3, TWO RIVERS, WI 54241-3043
(920) 553-8993
(920) 553-8990
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1275-019
WI
2255A2300X
Athletic Trainer
605-039
WI
Other
Enumeration date
12/04/2006
Last updated
07/12/2010
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