Individual
MRS. REBECCA LYNN VANDERLOOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
316 E 14TH ST, KAUKAUNA, WI 54130-3304
(920) 766-6020
Mailing address
520 E 14TH ST, KAUKAUNA, WI 54130-3308
(920) 427-9737
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2056-19
WI
Other
Enumeration date
09/06/2014
Last updated
09/06/2014
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