Individual
KAELYN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Credential
DPT
Contact information
Practice address
W3124 VAN ROY RD, APPLETON, WI 54915-3929
(920) 968-1010
(920) 968-1012
Mailing address
2105 E ENTERPRISE AVE STE 113, APPLETON, WI 54913-7862
(920) 991-2561
(920) 991-2563
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17294-24
WI
Other
Enumeration date
06/02/2025
Last updated
06/02/2025
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