Amanda Deremo

Organization Active NPI Exclusive Provider Organization · Janesville, WI

NPI 1922400563 · NPPES record last updated Sep 25, 2014

Key facts

NPI
1922400563
Entity type
Organization (NPI type 2)
Primary specialty
Exclusive Provider Organization 302F00000X
License
318603 (WI)
Legal business name
AMANDA DEREMO
Practice address
82 Falling Creek Cir
Janesville, WI 53548-9106
Phone
(608) 449-1399
NPI assigned
Sep 25, 2014
Organization subpart
No

Authorized official

Name
Amanda Deremo
Title
Employer
Phone
(608) 449-1399

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 318603 WI Yes

Addresses

Primary practice location

82 Falling Creek Cir
Janesville, WI 53548-9106

Mailing address

82 Falling Creek Cir
Janesville, WI 53548-9106
Phone (608) 449-1399

Other providers in Janesville, WI

All providers in Janesville, WI · Exclusive Provider Organization in Wisconsin

Sources for this page

Verify at the official NPI Registry.