Individual
MRS. SANDRA JEAN PATZKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
W7738 STATE QUARRY LN, AMBERG, WI 54102-9250
(715) 759-5623
(715) 759-5623
Mailing address
W7738 STATE QUARRY LN, AMBERG, WI 54102-9250
(715) 759-5623
(715) 759-5623
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1801-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P320-7905-9842-02
DRIVERS LICENSE
WI
Enumeration date
10/12/2011
Last updated
10/12/2011
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