Individual
SANDRA LAUREEN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
30252 TOMAS STE 100, RANCHO SANTA MARGARITA, CA 92688-2181
(949) 459-1658
(949) 459-1667
Mailing address
15004 204TH AVE SE, RENTON, WA 98059-8916
(206) 409-6854
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT
CA
Other
Enumeration date
07/10/2017
Last updated
07/10/2017
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