Individual
DR. SANDRA LYNN MODAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 N 92ND ST, MILWAUKEE, WI 53226-3533
(414) 479-9233
(414) 259-0575
Mailing address
1245 SPINNAKER DR, PORT WASHINGTON, WI 53074-1389
(414) 640-9646
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1086
WI
Other
Enumeration date
12/14/2021
Last updated
12/14/2021
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