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Individual

TREVER WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
1110 W OMAHA ST, # 3, RAPID CITY, SD 57701-8120
(605) 721-5950
Mailing address
6855 DAISY DR, BLACK HAWK, SD 57718-8202
(605) 770-7331

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1898
SD

Other

Enumeration date
06/07/2016
Last updated
06/07/2016
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