Organization
VALPONI&WAGNER PHYSICAL THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY M WAGNER PT, CHT (OWNER)
(530) 894-0221
Entity
Organization
Contact information
Practice address
1430 ESPLANADE, #8, CHICO, CA 95926-3366
(530) 894-0221
(530) 894-0285
Mailing address
1430 ESPLANADE, #8, CHICO, CA 95926-3366
(530) 894-0221
(530) 894-0285
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
697197
ACN
CA
01
—
OPT101350
BLUE SHIELD
CA
05
—
PT0101350
—
CA
Enumeration date
09/07/2006
Last updated
07/11/2023
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