Individual
ALEX WAGNER
Active
Individual
ALEX WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3834
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3834
STATE OF NE
—
05
—
47065477701
—
NE
Enumeration date
07/25/2018
Last updated
08/08/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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