Individual
AMANDA JOY EVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1504 REFSET DR, JANESVILLE, WI 53545-0462
(608) 609-0728
Mailing address
1504 REFSET DR, JANESVILLE, WI 53545-0462
(608) 609-0728
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
10910-146
WI
Other
Enumeration date
05/29/2015
Last updated
05/29/2015
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