Individual
AMANDA S THOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3014 ERIE AVE, SHEBOYGAN, WI 53081-3658
(920) 453-7087
Mailing address
3014 ERIE AVE, SHEBOYGAN, WI 53081-3658
(920) 459-3028
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1165019
WI
Other
Enumeration date
05/15/2008
Last updated
08/25/2010
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