Individual
AMY HIRATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
202 S PARK ST, MADISON, WI 53715-1507
(608) 267-6173
Mailing address
202 S PARK ST, MADISON, WI 53715-1507
(608) 417-6000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5659-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5659-024
STATE LICENSE
WI
Enumeration date
12/06/2006
Last updated
12/31/2014
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