MICAIAH WAGNER

FORT SMITH, AR
NPI1538018189
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: OK  6526)
Enumeration Date2026-01-27
Last Update Date2026-01-27
Business Address
MICAIAH WAGNER DPT
5400 GARY ST
FORT SMITH, AR 72903-4744
Phone number: 918-658-0975
Mailing Address
MICAIAH WAGNER DPT
411 BETTY LOU RD
POTEAU, OK 74953-5221
Phone number: 918-658-0975
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