KEVIN MATTHEW WAGNER

BRIDGETON, MO
NPI1295735926
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: MO  115026)
Enumeration Date2005-07-22
Last Update Date2010-04-29
Business Address
Mr. KEVIN MATTHEW WAGNER MD PT Cert MDT
11903 SAINT CHARLES ROCK RD
BRIDGETON, MO 63044-2623
Phone number: 314-770-0900
Mailing Address
Mr. KEVIN MATTHEW WAGNER MD PT Cert MDT
BACK PAIN INSTITUTE OF ST. LOUIS LLC 11903 ST. CHARLES ROCK RD.
BRIDGETON, MO 63044
Phone number: 314-770-0900
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