Individual
AMANDA PASCAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2031 PEACH ST, WISCONSIN RAPIDS, WI 54494-5181
(715) 423-0122
Mailing address
507 NORTH 17TH ST, MILWAUKEE, WI 53233
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/28/2022
Last updated
11/18/2022
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