Individual
ANDREA L MCCARTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1190 E PARADISE DR, WEST BEND, WI 53095-5444
(262) 306-6319
(262) 306-2964
Mailing address
1700 W PARADISE DR, WEST BEND, WI 53095-9795
(262) 334-3451
(262) 306-2964
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11465
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11465
WI TEMPORARY LICENSE
WI
Enumeration date
06/08/2010
Last updated
06/08/2010
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