Provider Demographics
NPI:1720318629
Name:TROTZER, AMY MARIE (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:TROTZER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:MARIE
Other - Last Name:ROBAZEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:704 SCHMIDT AVE
Mailing Address - Street 2:
Mailing Address - City:ROTHSCHILD
Mailing Address - State:WI
Mailing Address - Zip Code:54474-1246
Mailing Address - Country:US
Mailing Address - Phone:715-574-2510
Mailing Address - Fax:
Practice Address - Street 1:2402 GRAND AVE
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54403-6918
Practice Address - Country:US
Practice Address - Phone:715-842-7707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-28
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5249-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist