| NPI | 1447546650 |
|---|---|
| Former Name | JULIE M WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05014892A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT021294) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2024-02-13 |