Individual
DR. PATRICK WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
8751 W CHARLESTON BLVD STE 270, LAS VEGAS, NV 89117-5497
(702) 982-2232
Mailing address
8751 W CHARLESTON BLVD STE 270, LAS VEGAS, NV 89117-5497
(702) 982-2232
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4291
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4291
STATE LICENSE
NV
Enumeration date
06/08/2020
Last updated
06/08/2020
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