Individual
DR. KIMBERLY N WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
750 CORONADO CENTER DR, SUITE 120, HENDERSON, NV 89052-5034
(702) 564-4116
Mailing address
6617 SUNSET PINES ST, LAS VEGAS, NV 89148-4251
(903) 453-1709
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
2757
NV
Other
Enumeration date
09/13/2012
Last updated
09/30/2019
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