Individual
MRS. WANDA LEA WALKOWIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
30 VT ROUTE 100 S, WILMINGTON, VT 05363-7944
(802) 464-3151
(802) 464-3116
Mailing address
PO BOX 716, WILMINGTON, VT 05363-0716
(802) 464-3151
(802) 464-3116
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0400003361
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00068343
BCBS
VT
01
—
382118
MVP
—
Enumeration date
08/07/2006
Last updated
07/25/2013
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