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1619365681
MIRANDA MARIE HERMES
GREEN BAY, WI
NPI
1619365681
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: WI 2213-19)
Enumeration Date
2014-12-29
Last Update Date
2014-12-29
Business Address
-- MIRANDA MARIE HERMES PTA
2305 SAN LUIS PLACE
GREEN BAY, WI 54304-5211
Phone number: 920-494-2817
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Mailing Address
-- MIRANDA MARIE HERMES PTA
2305 SAN LUIS PLACE
GREEN BAY, WI 54304-5211
Phone number: 920-494-2817
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