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1821360355
MICHAEL JEROME WENCLAWIAK
AUSTELL, GA
NPI
1821360355
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: GA PT003445)
Enumeration Date
2012-01-30
Last Update Date
2012-01-30
Business Address
Mr. MICHAEL JEROME WENCLAWIAK PT
3999 AUSTELL RD. SUITE 701
AUSTELL, GA 30106
Phone number: 770-739-0090
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Mailing Address
Mr. MICHAEL JEROME WENCLAWIAK PT
6067 GENTLEWIND CT
POWDER SPRINGS, GA 30127-6316
Phone number: 678-838-5194
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