Individual
ROSEMARIE M WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
100 FODEN RD, WEST, SUITE 205, SOUTH PORTLAND, ME 04106-2327
(207) 780-8860
(207) 780-8857
Mailing address
100 FODEN RD, WEST, SUITE 203, SOUTH PORTLAND, ME 04106-2327
(207) 828-0361
(207) 874-1483
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT501
ME
Other
Enumeration date
01/17/2006
Last updated
01/03/2013
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