Organization
AMANDA DEREMO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA DEREMO (EMPLOYER)
(608) 449-1399
Entity
Organization
Contact information
Practice address
82 FALLING CREEK CIR, JANESVILLE, WI 53548-9106
(608) 449-1399
Mailing address
82 FALLING CREEK CIR, JANESVILLE, WI 53548-9106
(608) 449-1399
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
318603
WI
Other
Enumeration date
09/25/2014
Last updated
09/25/2014
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