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Individual

AMANDA C LANGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2321 STOUT ROAD, MENOMONIE, WI 54751-7003
(715) 838-5222
Mailing address
200 1ST ST SW, SUITE 2000, ROCHESTER, MN 55905-0001
(507) 284-2511

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.004518
IL
363A00000X
Physician Assistant
Primary
3709-23
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1295088821
WI
Enumeration date
10/19/2012
Last updated
02/06/2026
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