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Individual
PATRICIA MARY WAGEL
Active
Individual
PATRICIA MARY WAGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501004088
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650H229750
BCBS
MI
01
—
P00442692
MEDICARE RAILROAD PTAN
MI
Enumeration date
07/28/2006
Last updated
02/28/2018
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