Individual
MRS. ERIN L WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, LMT
Contact information
Practice address
69 RAILROAD AVE STE A4, HILO, HI 96720-7509
(808) 339-7861
(808) 339-7989
Mailing address
25-3420 PAKELEKIA ST, HILO, HI 96720-1318
(808) 987-1879
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-192
HI
225700000X
Massage Therapist
MAT-14701
HI
Other
Enumeration date
06/08/2017
Last updated
06/08/2017
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