Individual
MS. CHRISTINE KAY WAGNER IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
950 E PARK ST, PIERRE, SD 57501-4154
(605) 224-8628
(605) 224-6948
Mailing address
950 E PARK ST, PIERRE, SD 57501-4154
(605) 224-8628
(605) 224-6948
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
0047
SD
Other
Enumeration date
11/09/2007
Last updated
11/09/2007
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