Individual
CARLYN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23271 VERDUGO DR, #B, LAGUNA HILLS, CA 92653-1347
(949) 707-5555
Mailing address
981 N VULCAN AVE, #5, ENCINITAS, CA 92024-1720
(760) 815-2198
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
26019
CA
Other
Enumeration date
05/16/2007
Last updated
05/19/2022
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