Individual
LYDIE VAGNEROVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1580 E RIVER RD, TUCSON, AZ 85718-7629
(520) 207-2191
Mailing address
1580 E RIVER RD, TUCSON, AZ 85718-7629
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10077A
AZ
Other
Enumeration date
11/15/2017
Last updated
11/15/2017
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