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Individual

MRS. AMANDA JO HARTMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSOTR

Contact information

Practice address
709 SPRING VALLEY RD, BURLINGTON, WI 53105-7614
(262) 971-9300
Mailing address
705 248TH AVE, KANSASVILLE, WI 53139-9650
(262) 806-6235

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5240-26
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5240-26
DIVISION OF PROFESSIONAL CREDENTIAL PROCESSING DEPARTMENT OF SAFETY AND PROFESSI
WI
Enumeration date
08/07/2020
Last updated
08/07/2020
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