Individual
AMANDA M PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7300 WASHINGTON AVE, RACINE, WI 53406-6525
(262) 321-6000
Mailing address
7300 WASHINGTON AVE, RACINE, WI 53406-6525
(262) 321-6000
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1103-019
WI
Other
Enumeration date
08/14/2009
Last updated
08/14/2009
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