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General NPI Number Information
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NPI Number | 1437827458
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Entity Type | Individual
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Provider Name | DEVON ANDERSON PT
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Gender | Female
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Dates
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Enumeration Date | 09/03/2021
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 916 E CLIFFORD ST
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City | PLYMOUTH
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State | WI
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Zip | 53073-2468
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Country | US
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Telephone | 510-367-0520
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Fax |
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Provider Business Mailing Address
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Address Line | N7310 HIGHVIEW RD
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City | PLYMOUTH
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State | WI
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Zip | 53073-2787
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 15745-24
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License Number State | WI
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