Individual
MICHELE WACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8580 VERREE RD, PHILA, PA 19111-1370
(215) 214-2840
Mailing address
602 MAGEE AVE, PHILA, PA 19111-4716
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI000867
PA
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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