Individual
TINA MARIE WANNER
Active
Individual
TINA MARIE WANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT2029
NV
225100000X
Physical Therapist
2029
NV
Other
Enumeration date
10/17/2017
Last updated
10/17/2017
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