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1003141433
MICHELLE RENAE WAGONER
PEORIA, AZ
NPI
1003141433
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: AZ 8684)
Enumeration Date
2009-10-02
Last Update Date
2009-10-02
Business Address
-- MICHELLE RENAE WAGONER PT, DPT
9713 W TONOPAH DR
PEORIA, AZ 85382-5110
Phone number: 480-381-0220
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Mailing Address
-- MICHELLE RENAE WAGONER PT, DPT
9713 W TONOPAH DR
PEORIA, AZ 85382-5110
Phone number: 480-381-0220
Copy
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