Doctor Name: | KODY D WAGNER |
NPI Number: | 1093124653 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT, DPT |
License Number: | PT023664 |
Business Practice Address: | 150 Wayland Smith Dr Suite A Uniontown, PA - 154012677 |
Business Phone Number: | 7244378200 |
Business Fax Number: | |
Mailing Address: | 150 Wayland Smith Dr, Suite A UNIONTOWN |
State: | PA |
Postal Code: | 154012677 |
Phone Number: | 7244378200 |
Fax Number: | |
NPI Enumeration Date: | 08/07/2014 |
NPI Last Update Date: | 08/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT023664 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |