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Individual

DR. CARISSA MARIE WENGROVIUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.T., D.P.T.

Contact information

Practice address
801 MAIN ST STE 10, LOUISVILLE, CO 80027-1898
(303) 604-6441
Mailing address
9538 CASTLE RIDGE CIR, HIGHLANDS RANCH, CO 80129-5701
(303) 859-9459

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
0012318
CO

Other

Enumeration date
08/06/2013
Last updated
08/06/2013
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