| Doctor Name: | AMANDA B STROM |
| NPI Number: | 1477888345 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 2516 |
| Business Practice Address: | 1120 Main St Union Grove, WI - 531821328 |
| Business Phone Number: | 2628784424 |
| Business Fax Number: | |
| Mailing Address: | 1120 Main St, UNION GROVE |
| State: | WI |
| Postal Code: | 531821328 |
| Phone Number: | 2628784424 |
| Fax Number: | |
| NPI Enumeration Date: | 10/12/2009 |
| NPI Last Update Date: | 10/12/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 2516 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |