Individual
MARIANNE E WILDGUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
88 PARK ST, RUTLAND, VT 05701-4710
(802) 775-7612
Mailing address
259 RICHMOND RD, BRANDON, VT 05733-8932
(802) 247-3119
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
040-0000902
VT
Other
Enumeration date
02/07/2007
Last updated
07/08/2007
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