Individual
SARA WAGNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
215 W CORNWALL CT, LAFAYETTE, CO 80026-1161
(970) 903-8876
Mailing address
215 W CORNWALL CT, LAFAYETTE, CO 80026-1161
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0013728
CO
Other
Enumeration date
12/07/2015
Last updated
12/07/2015
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