JACK A WAGSTROM

NORTH CANTON, OH
NPI1104188309
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: OH  PTA. 1596)
Enumeration Date2012-06-13
Last Update Date2012-06-13
Business Address
-- JACK A WAGSTROM
339 E MAPLE ST
NORTH CANTON, OH 44720-2593
Phone number: 330-498-8200
Mailing Address
-- JACK A WAGSTROM
339 E MAPLE ST
NORTH CANTON, OH 44720-2593
Phone number:
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