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Individual
JAMES WAGNER
Active
Individual
JAMES WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTD
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC004205L
PA
Other
Enumeration date
06/17/2015
Last updated
03/18/2021
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