Individual
KAYLA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT,DPT,ATC
Contact information
Practice address
111 W 10TH AVE, REDFIELD, SD 57469-1519
(605) 472-1110
Mailing address
111 W 10TH AVE, PO BOX 420, REDFIELD, SD 57469-1519
(605) 472-1110
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1897
SD
Other
Enumeration date
07/01/2016
Last updated
07/01/2016
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