Individual
LINDA WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5216 DORCHESTER DR, ERIE, PA 16509-2500
(585) 503-0405
Mailing address
5216 DORCHESTER DR, ERIE, PA 16509-2500
(585) 503-0405
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC-009261
PA
Other
Enumeration date
04/09/2007
Last updated
09/22/2016
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