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Individual

HEIDI VANDENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
8400 SHERIDAN RD, KENOSHA, WI 53143-6327
(262) 658-4141
Mailing address
8400 SHERIDAN RD, KENOSHA, WI 53143-6327

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1606-019
WI

Other

Enumeration date
12/15/2009
Last updated
12/15/2009
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