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1710324298
ERIK WAGNER
SPRINGFIELD, IL
NPI
1710324298
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070018116)
Enumeration Date
2013-05-24
Last Update Date
2013-05-24
Business Address
-- ERIK WAGNER
800 E CARPENTER ST
SPRINGFIELD, IL 62769-1000
Phone number: 217-544-6464
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Mailing Address
-- ERIK WAGNER
3712 WINDSHIRE DR
SPRINGFIELD, IL 62704-6718
Phone number:
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