| Doctor Name: | KAITLIN WAGNER |
| NPI Number: | 1154797348 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 0013544 |
| Business Practice Address: | 7395 W Eastman Pl Lakewood, CO - 802275006 |
| Business Phone Number: | 3037308000 |
| Business Fax Number: | |
| Mailing Address: | 2795 N Speer Blvd, A-348 DENVER |
| State: | CO |
| Postal Code: | 802114270 |
| Phone Number: | 6032543430 |
| Fax Number: | |
| NPI Enumeration Date: | 08/11/2015 |
| NPI Last Update Date: | 08/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 0013544 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| 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 |