Provider Demographics
NPI:1245569730
Name:VOELLER, SANDREA (RDMS)
Entity Type:Individual
Prefix:
First Name:SANDREA
Middle Name:
Last Name:VOELLER
Suffix:
Gender:F
Credentials:RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6502 GRAND TETON PLZ
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1047
Mailing Address - Country:US
Mailing Address - Phone:608-203-8333
Mailing Address - Fax:608-203-8334
Practice Address - Street 1:6502 GRAND TETON PLZ
Practice Address - Street 2:SUITE 105
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1047
Practice Address - Country:US
Practice Address - Phone:608-203-8333
Practice Address - Fax:608-203-8334
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI191292471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography