Provider Demographics
NPI:1598747594
Name:AMUNDSON, MARGARET JOAN (AT,C)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:JOAN
Last Name:AMUNDSON
Suffix:
Gender:F
Credentials:AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 E KING ST
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-3441
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1903 LINCOLN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-3674
Practice Address - Country:US
Practice Address - Phone:715-369-1001
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI434-0392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer