BETHANY WAGENBACH

PEORIA, IL
NPI1801460266
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: IL  160.009110)
Enumeration Date2021-05-19
Last Update Date2021-05-19
Business Address
BETHANY WAGENBACH PTA
6809 N KNOXVILLE AVE
PEORIA, IL 61614-2812
Phone number: 309-981-8810
Mailing Address
BETHANY WAGENBACH PTA
507 S WARREN ST
TREMONT, IL 61568-8565
Phone number:
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