Individual
CECYLE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
8550 LEE HWY STE 450, FAIRFAX, VA 22031-1519
(703) 208-1002
(703) 208-1127
Mailing address
706 N WILLIAMS, MESA, AZ 85203-6639
(480) 282-0449
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
14660
TN
225100000X
Physical Therapist
Primary
CP024217T
VA
225100000X
Physical Therapist
LPT-31756
AZ
Other
Enumeration date
05/19/2021
Last updated
08/09/2023
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