Individual
MELISSA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
543 HIGHWAY 17 N, NORTH MYRTLE BEACH, SC 29582-2903
(843) 390-8254
Mailing address
247 SIENNA DR, LITTLE RIVER, SC 29566-7095
(856) 308-6636
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10287
SC
Other
Enumeration date
02/25/2017
Last updated
11/17/2025
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