Individual
NATHAN WILLIAM WAAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1700 18TH AVE, GREELEY, CO 80631-5134
(970) 353-3370
Mailing address
334 52ND AVE, GREELEY, CO 80634-4224
(970) 371-8208
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
12057
CO
Other
Enumeration date
03/27/2012
Last updated
03/27/2012
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