Individual
MISS ANN-MARIE WURZBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
428 N IMPERIAL AVE, EL CENTRO, CA 92243-2329
(760) 353-3422
(760) 353-9163
Mailing address
1985 CHAMBERS LN, HOLTVILLE, CA 92250-9533
(760) 356-1150
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 13114
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPT131140
BLUE SHIELD
CA
Enumeration date
06/01/2005
Last updated
07/08/2007
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