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Individual

MR. WADE RIO WUTSCHKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
2500 HIGHWAY 88, SUITE 219, ST ANTHONY, MN 55418-4223
(612) 554-9390
Mailing address
645 3RD AVE NW, NEW BRIGHTON, MN 55112-6840
(612) 554-9390

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MN
225700000X
Massage Therapist
Primary

Other

Enumeration date
04/24/2014
Last updated
04/24/2014
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