Individual
MAX WAGONHEIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
515 BRIGHTFIELD RD, LUTHERVILLE, MD 21093-3643
(410) 296-1990
Mailing address
515 BRIGHTFIELD RD, LUTHERVILLE, MD 21093-3643
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A4037
MD
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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