Individual
SANDRA WAGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6100 MILLER AVE, GARY, IN 46403-2469
(219) 427-0196
Mailing address
6100 MILLER AVE, GARY, IN 46403-2469
(219) 427-0196
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06006001A
IN
Other
Enumeration date
01/28/2020
Last updated
01/28/2020
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