Individual
AMY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1142 ORLANDO DR, DE PERE, WI 54115-9484
(920) 339-0700
(920) 330-0278
Mailing address
1127 ALDRIN ST, DE PERE, WI 54115
(920) 680-0284
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2119-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40278500
—
WI
Enumeration date
03/22/2007
Last updated
04/14/2008
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