Individual
MR. ANDREW THOMAS WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT ATC
Contact information
Practice address
6863 HOLLOPETER RD, LEO, IN 46765-9269
(260) 797-2572
Mailing address
6863 HOLLOPETER RD, LEO, IN 46765-9269
(260) 797-2572
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05007988A
IN
Other
Enumeration date
10/19/2006
Last updated
05/11/2026
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