Individual
MISS BARBARA LYNETTE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
820 COTTAGE ST NE, SALEM, OR 97301-2426
(503) 399-0202
Mailing address
1824 DENALI DR E, MONMOUTH, OR 97361-1883
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
252548
OR
Other
Enumeration date
11/11/2009
Last updated
11/11/2009
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