Individual
MIRA KARAGODSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13111 N PORT WASHINGTON RD, MEQUON, WV 53024
(262) 243-7465
Mailing address
805 LAMPLIGHTER LN, GRAFTON, WI 53024-9349
(262) 375-2128
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9539024
WI
Other
Enumeration date
06/16/2006
Last updated
07/08/2007
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