Individual
SARA WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
305 S CLARK ST, MAYVILLE, WI 53050-1488
(920) 387-1372
(920) 387-1370
Mailing address
305 S CLARK ST, MAYVILLE, WI 53050-1488
(920) 387-1372
(920) 387-1370
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2439-19
WI
Other
Enumeration date
12/20/2016
Last updated
12/20/2016
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