Individual
CHRISTOPHER J WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
23588
MD
225100000X
Physical Therapist
Primary
J10002581
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01033233
MEDICARE RAILROAD
MD
Enumeration date
03/19/2010
Last updated
06/21/2012
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