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1508383506
KOREN R WAGNER
RALEIGH, NC
NPI
1508383506
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: NC 11729)
Enumeration Date
2017-08-29
Last Update Date
2017-08-29
Business Address
KOREN R WAGNER PT, DPT
10211 ALM ST
RALEIGH, NC 27617-8221
Phone number: 919-206-4868
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Mailing Address
KOREN R WAGNER PT, DPT
143 LONG SHADOW PL
DURHAM, NC 27713-8639
Phone number: 949-677-6927
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