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NPI Code Detail

MEDICARE: AMIE C HOAGLAND P.T.

MEDICARE: AMIE C HOAGLAND P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist9743-024WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255318226
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMIE C HOAGLAND P.T.
Provider Business Mailing Address
First Line : N72W16078 GOOD HOPE RD
Second Line :
City : MENOMONEE FALLS
State : WI
Zip : 53051-4552
Country : US
Telephone Number : 262-502-1844
Fax Number :
Provider Business Practice Location Address
First Line : 4214 SHERIDAN RD
Second Line :
City : RACINE
State : WI
Zip : 53403-4142
Country : US
Telephone Number : 262-554-6515
Fax Number : 262-554-6892
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2005
Last Update Date : 07/08/2007

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Directions to “ AMIE C HOAGLAND P.T.” Practice Location

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