Individual
MS. ANDREA PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
6520 W LAYTON AVE, 101, GREENFIELD, WI 53220-4500
(414) 727-3340
(414) 282-9348
Mailing address
3037 W IONA TER, #3, MILWAUKEE, WI 53221-5510
(262) 327-4265
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
600-19
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
600-19
P.T.A. LICENSE
WI
Enumeration date
03/31/2010
Last updated
03/31/2010
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