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1083050728
GENEVIEVE AMANDA WAGNER
SPRINGFIELD, IL
NPI
1083050728
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070017303)
Enumeration Date
2013-05-21
Last Update Date
2013-05-21
Business Address
Mrs. GENEVIEVE AMANDA WAGNER DPT
800 E CARPENTER ST
SPRINGFIELD, IL 62769-1000
Phone number: 217-544-6464
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Mailing Address
Mrs. GENEVIEVE AMANDA WAGNER DPT
800 E CARPENTER ST
SPRINGFIELD, IL 62769-1000
Phone number: 217-544-6464
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