Individual
AMANDA WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1320 INDIANWOOD DR, BROOKFIELD, WI 53005-5511
(262) 271-7261
Mailing address
1320 INDIANWOOD DR, BROOKFIELD, WI 53005-5511
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12679-24
WI
Other
Enumeration date
08/26/2015
Last updated
08/26/2015
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