Individual
GARRET ANTHONY WADSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2797 SAN ANDRES CT APT B, HOLLOMAN AFB, NM 88330-7140
(505) 479-1050
Mailing address
2797B SAN ANDREAS, HOLLOMAN AFB, NM 88330
(505) 479-1050
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1119782
TX
Other
Enumeration date
03/09/2007
Last updated
07/08/2007
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