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Individual

MRS. SARAH WAGONER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
3600 BROADWAY, OAKLAND, CA 94611-5730
(510) 752-6561
Mailing address
3600 BROADWAY, OAKLAND, CA 94611-5730

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
41035
CA

Other

Enumeration date
10/21/2015
Last updated
01/11/2022
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