Individual
MS. LYNDA SUE WAGNER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
207 BALSAM RD, JACKSONVILLE, NC 28546-8574
(910) 526-9325
Mailing address
207 BALSAM RD, JACKSONVILLE, NC 28546-8574
(910) 526-9325
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
OT 7775
CA
Other
Enumeration date
01/19/2006
Last updated
07/08/2007
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