# MS. ADRIAN WAGNER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1639302995
- **Gender:** F
- **Credential:** DPT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 031554-1 | NY | — |
| 225100000X | Physical Therapist | 070.017317 | IL | Yes |

## Other

- **Enumeration date:** 09/02/2009
- **Last updated:** 09/02/2009