Individual
MR. DAVID C WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3105 MAIN ST, MARLETTE, MI 48453-1508
(989) 635-3660
(989) 635-3662
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501003073
MI
Other
Enumeration date
07/31/2006
Last updated
06/16/2014
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