Fetterer, Samantha Lyn

Fetterer, Samantha Lyn is an sole proprietor health care provider with primary practice located at 2629 N 7Th St , Sheboygan WI 53083-4932. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Fetterer, Samantha Lyn can be contacted via phone (920) 451-5550.

Contact Information

Primary practice address
2629 N 7Th St Sheboygan WI 53083-4932
Phone: (920) 451-5550
Fax: (920) 451-5664
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 74-019 Wisconsin

Profile Details

NPI number 1740492404
LBN Legal business name Fetterer, Samantha Lyn
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 4th, 2007
Last updated Oct 30th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740492404 NPPES
Wisconsin MEDICAID 40469600

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