Individual
MRS. AMY JEANNE TEZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
5700 W LAYTON AVE, GREENFIELD, WI 53220-4016
(414) 281-7200
Mailing address
5700 W LAYTON AVE, GREENFIELD, WI 53220-4016
(414) 281-7200
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2920-026
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40865900
—
WI
Enumeration date
04/11/2008
Last updated
04/11/2008
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