Individual
MRS. AMBER WIRTALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2517 BROADWAY DR, TROPHY CLUB, TX 76262-5040
(615) 878-5620
Mailing address
2517 BROADWAY DR, TROPHY CLUB, TX 76262-5040
(615) 878-5620
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
118449
TX
Other
Enumeration date
10/28/2016
Last updated
02/22/2022
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