MRS. Tammy Luella Gagnon, PTA

NPI #1487953592 in Wautoma, Wisconsin

Provider Information

NPI Number: 1487953592
Entity Type: Individual
Name: MRS. Tammy Luella Gagnon, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Mar 16, 2011
Last Updated: Mar 16, 2011

Practice Location

Address: W6990 S SILVER LAKE RD
City: Wautoma
State: Wisconsin
ZIP Code: 54982-5890
Phone: (920) 787-4766

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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