Individual
JENNIFER VANDERKAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
W231N1440 CORPORATE CT, WAUKESHA, WI 53186-1303
(262) 896-6045
Mailing address
W231N1440 CORPORATE CT, WAUKESHA, WI 53186-1303
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2004-19
WI
Other
Enumeration date
10/05/2016
Last updated
07/02/2019
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