Individual
DR. JADALYN LANE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
20288 HIGHWAY 15 N STE 100, HUTCHINSON, MN 55350-5685
(320) 244-2437
(320) 234-6358
Mailing address
1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112-1789
(651) 628-9566
(651) 628-0411
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
107577
MN
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
05/30/2024
Last updated
11/15/2024
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