Individual
ELISABETH WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4498 MAIN ST., SUITE 24, AMHERST, NY 14226
(716) 839-1550
(716) 839-1696
Mailing address
4498 MAIN ST., SUITE 24, AMHERST, NY 14226
(716) 839-1550
(716) 839-1696
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
01075581
NY
Other
Enumeration date
09/26/2017
Last updated
09/26/2017
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