Individual
STACY SMITH WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
1481 CHAPEL ST, NEW HAVEN, CT 06511
(203) 776-9110
(203) 777-5879
Mailing address
1481 CHAPEL ST, NEW HAVEN, CT 06511-4305
(203) 776-9110
(203) 777-5879
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9052
CT
Other
Enumeration date
05/11/2011
Last updated
12/18/2023
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