Individual
MICHAEL WAGAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
529 INDUSTRIAL BLVD STE 101, GRAPEVINE, TX 76051-8609
(817) 313-2988
Mailing address
529 INDUSTRIAL BLVD STE 101, GRAPEVINE, TX 76051-8609
(817) 313-2988
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
3131281
TX
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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