Individual
HEIDI WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.P.O.
Contact information
Practice address
6320 N CENTER DR, BLDG #15 SUITE 201, NORFOLK, VA 23502-4009
(757) 892-5300
Mailing address
6320 N. CENTER AVE., BLDG #15 SUITE 201, NORFOLK, VA 23502
(757) 892-5300
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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