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1740492404
SAMANTHA LYN FETTERER
SHEBOYGAN, WI
NPI
1740492404
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: WI 74-019)
Enumeration Date
2007-05-04
Last Update Date
2007-10-30
Business Address
MRS. SAMANTHA LYN FETTERER PTA
2629 N 7TH ST
SHEBOYGAN, WI 53083-4932
Phone number: 920-451-5550
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Mailing Address
MRS. SAMANTHA LYN FETTERER PTA
2120 BROADWAY AVENUE
SHEBOYGAN, WI 53081
Phone number: 920-803-8316
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