Individual
DEANNA BOETTCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
252 MCHENRY ST, BURLINGTON, WI 53105-1828
(262) 763-2411
Mailing address
252 MCHENRY ST, BURLINGTON, WI 53105-1828
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10036-7000
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40390500
—
WI
Enumeration date
06/13/2007
Last updated
06/05/2024
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