Individual
AMANDA M MORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2835 N GRANDVIEW BLVD, SUITE 100, PEWAUKEE, WI 53072-5531
(262) 574-5185
(262) 574-5193
Mailing address
2500 N MAYFAIR RD, STE 500, WAUWATOSA, WI 53226-1415
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
000683042
WI
Other
Enumeration date
09/26/2006
Last updated
01/22/2018
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