Provider Demographics
NPI:1184899056
Name:ARTZ, ANDREA N (MS, PT)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:N
Last Name:ARTZ
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1486 W MEQUON RD
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-3268
Mailing Address - Country:US
Mailing Address - Phone:218-260-6933
Mailing Address - Fax:262-241-8304
Practice Address - Street 1:1486 W MEQUON RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-3268
Practice Address - Country:US
Practice Address - Phone:218-260-6933
Practice Address - Fax:262-241-8304
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10613-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist