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1134279060
DIANE J WAUTERS
GREEN BAY, WI
NPI
1134279060
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: WI 2404)
Enumeration Date
2007-01-11
Last Update Date
2007-07-08
Business Address
-- DIANE J WAUTERS PT
835 S VAN BUREN ST
GREEN BAY, WI 54301-3526
Phone number: 920-433-0111
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Mailing Address
-- DIANE J WAUTERS PT
PO BOX 13508
GREEN BAY, WI 54307-3508
Phone number: 920-433-0111
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