Individual
MR. HOWARD KENNETH WAGENHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT LICENSED PHYSICA
Contact information
Practice address
5411 OLD FREDERICK RD, #16, BALT, MD 21229
(410) 747-0158
(410) 747-3828
Mailing address
5411 OLD FREDERICK RD, #16, BALT, MD 21229
(410) 747-0158
(410) 747-3828
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13512
MD
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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