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1346856846
CAITLYN CLARE WAGENBACH
PEORIA HEIGHTS, IL
NPI
1346856846
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Former Name
CAITLYN CLARE HONAN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2020-09-20
Last Update Date
2024-10-22
Business Address
Mrs. CAITLYN CLARE WAGENBACH PA-C
4616 N PROSPECT RD
PEORIA HEIGHTS, IL 61616-6460
Phone number: 217-528-7541
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Mailing Address
Mrs. CAITLYN CLARE WAGENBACH PA-C
PO BOX 19248
SPRINGFIELD, IL 62794-9248
Phone number: 217-528-7541
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