Waller, Amanda

Waller, Amanda is an individual health care provider with primary practice located at 19 W Newton St , Rice Lake WI 54868-1744. 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. Waller, Amanda can be contacted via phone (715) 234-2161.

Contact Information

Primary practice address
19 W Newton St Rice Lake WI 54868-1744
Phone: (715) 234-2161
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 2319-19 Wisconsin

Profile Details

NPI number 1134504657
LBN Legal business name Waller, Amanda
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2015
Last updated Jul 26th, 2015 - about 10 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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