| Amanda Joelle Uttech, | |
|
700 Geneva Pkwy, Lake Geneva, WI 53147-4594 | |
| (262) 249-3500 | |
| Not Available |
| Full Name | Amanda Joelle Uttech |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 700 Geneva Pkwy, Lake Geneva, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699444190 | NPI | - | NPPES |
| 100222713 | Medicaid | WI | |
| 15599-24 | Other | WI | STATE OF WISCONSIN LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 15599-24 (Wisconsin) | Primary |
| Provider Name | Advantage Physical Therapy & Sports Rehab, Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1881773463 PECOS PAC ID: 8022016336 Enrollment ID: O20061121000412 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Joelle Uttech, Po Box 735044, Chicago, IL 60673-5044 Ph: (262) 249-3500 | Amanda Joelle Uttech, 700 Geneva Pkwy, Lake Geneva, WI 53147-4594 Ph: (262) 249-3500 |
Erin E Mahoney, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 700 Geneva Pkwy N, Lake Geneva, WI 53147 Phone: 262-249-3500 | |
Matthew Allen Hoffman, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 700 Geneva Pkwy N, Lake Geneva, WI 53147 Phone: 262-249-3500 | |
Madalyn R Douglas, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: N2950 State Road 67, Lake Geneva, WI 53147 Phone: 262-245-4980 Fax: 262-245-2248 | |
Kelly J Pauley, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: N2950 State Road 67, Lake Geneva, WI 53147 Phone: 262-245-0535 | |
Kimberly K Dama, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: N2950 State Road 67, Lake Geneva, WI 53147 Phone: 262-245-0535 | |
Mrs. Tara M. Grocholski, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 700 Geneva Pkwy N, Lake Geneva, WI 53147 Phone: 262-249-3500 | |
Carling M. Johns, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: N2950 State Road 67, Lake Geneva, WI 53147 Phone: 800-638-2901 Fax: 262-245-2248 |