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1063580975
WANDA ILENE STEPHENS
COOKEVILLE, TN
NPI
1063580975
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: TN 2007)
Enumeration Date
2006-11-30
Last Update Date
2007-07-08
Business Address
Mrs. WANDA ILENE STEPHENS PTA
815 SOUTH WALNUT AVE
COOKEVILLE, TN 38501
Phone number: 931-646-7216
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Mailing Address
Mrs. WANDA ILENE STEPHENS PTA
3122 DEERHAVEN DRIVE S
ALGOOD, TN 38506
Phone number: 931-537-2144
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