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TODD J WAGNER MSPT

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1841339132

Individual Registrant:
 TODD J WAGNER MSPT
Gender: M
Not Sole Proprietor

Location and contact information for practice:
204 E JEFFERSON  WHITNEY, TX 76692 US
Tel: 254-694-6831  Fax: --

Contact information for business:
PO BOX 68  WHITNEY, TX 76692-0068 US
Tel: 254-694-6831  Fax: --

Registration Information:
NPI: 1841339132
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
TX1123479

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
161076801TX05




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