Individual
AMANDA RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
H.I.S.
Contact information
Practice address
N87 W16459 B WEST APPLETON, MENOMONEE FALLS, WI 53051
(262) 502-1799
Mailing address
140 CORPORATE DR, SUITE 1, BEAVER DAM, WI 53916-1281
(920) 887-9655
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
1174-060
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42834200
—
WI
Enumeration date
11/05/2007
Last updated
11/05/2007
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