Individual
MS. ADRIAN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
20060 GOVERNORS DR, OLYMPIA FIELDS, IL 60461-1029
(708) 283-1789
Mailing address
109 GROVER ST, EAST SYRACUSE, NY 13057-1748
(518) 378-8207
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
031554-1
NY
225100000X
Physical Therapist
Primary
070.017317
IL
Other
Enumeration date
09/02/2009
Last updated
09/02/2009
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