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Individual

DEVON ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
916 E CLIFFORD ST, PLYMOUTH, WI 53073-2468
(510) 367-0520
Mailing address
N7310 HIGHVIEW RD, PLYMOUTH, WI 53073-2787

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15745-24
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100183367
WI
Enumeration date
09/03/2021
Last updated
01/09/2025
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