Individual
MCKENNA MARIE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1500 N MISSISSIPPI ST, LITTLE ROCK, AR 72207-5851
(501) 217-8600
(501) 217-8636
Mailing address
10618 BRECKENRIDGE DR, LITTLE ROCK, AR 72211-1802
(501) 217-8600
(501) 217-8636
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5555
AR
Other
Enumeration date
09/26/2024
Last updated
03/26/2025
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