Individual
ANGEL GRACE WIRZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
729 PARK ST, ANTIGO, WI 54409-2745
(715) 623-2356
Mailing address
729 PARK ST, ANTIGO, WI 54409-2745
(715) 623-2356
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
1344-019
WI
310400000X
Assisted Living Facility
Primary
1344-019
WI
Other
Enumeration date
05/05/2008
Last updated
05/05/2008
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