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Organization
WAGNER PHYSICAL THERAPY INC
Active
Organization
WAGNER PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM H DWIGHT PT (OWNER ADMINISTRATOR)
(248) 866-4364
Entity
Organization
Contact information
Practice address
3105 MAIN ST, MARLETTE, MI 48453
(989) 635-3660
(989) 635-3662
Mailing address
42615 GARFIELD, CLINTON TOWNSHIP, MI 48038
(586) 412-2846
(586) 286-0427
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30758
BC
MI
Enumeration date
08/11/2006
Last updated
01/17/2008
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