Individual
PHILLIP JOHN WASSENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1110 COLUMBINE DR, HOLTON, KS 66436-8824
(785) 364-2116
Mailing address
190 145TH ST, WETMORE, KS 66550-9768
(785) 364-2116
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-02637
KS
Other
Enumeration date
09/13/2006
Last updated
07/08/2007
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