Individual
JULIE WANDTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
212 FAIRVIEW ST, CENTERBURG, OH 43011-8314
(740) 625-5774
Mailing address
2337 NARROW LEAF CT, LEWIS CENTER, OH 43035-9637
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002942
OH
Other
Enumeration date
08/17/2017
Last updated
08/17/2017
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