AMANDA WALLER

RICE LAKE, WI
NPI1134504657
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: WI  2319-19)
Enumeration Date2015-07-26
Last Update Date2015-07-26
Business Address
-- AMANDA WALLER
19 W NEWTON ST
RICE LAKE, WI 54868-1744
Phone number: 715-234-2161
Mailing Address
-- AMANDA WALLER
19 W NEWTON ST
RICE LAKE, WI 54868-1744
Phone number: 715-234-2161