Individual
ANGELA JEAN MODERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
717 E ALFRED ST, WEYAUWEGA, WI 54983-9024
(920) 867-3121
(920) 867-3997
Mailing address
717 E ALFRED ST, WEYAUWEGA, WI 54983-9024
(920) 867-3121
(920) 867-3997
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
856-019
WI
Other
Enumeration date
08/21/2008
Last updated
08/21/2008
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