Individual
CARA WAGNER
Active
Individual
CARA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-010861
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000355386
ANTHEM
OH
01
—
04764
PARAMOUNT
OH
05
—
2540021
—
OH
01
—
9388187
PHCS
OH
01
—
P00183681
RR MEDICARE
OH
01
—
WA4147071
ADMINISTAR FEDERAL
OH
Enumeration date
06/30/2006
Last updated
07/08/2007
Update your record
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