Individual
AMANDA J WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
700 N LAKE AVE, TWIN LAKES, WI 53181-9436
(262) 877-2124
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(262) 877-2124
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9848-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40371000
—
WI
Enumeration date
06/13/2007
Last updated
01/24/2022
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