Individual
PAULA ANNE-MARIE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
707 RUDY LN, LOUISVILLE, KY 40207-2347
(502) 974-0173
Mailing address
PO BOX 7347, LOUISVILLE, KY 40257-0347
(502) 974-0173
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002031
KY
Other
Enumeration date
09/21/2012
Last updated
09/21/2012
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