| Doctor Name: | NICOLE T WAGNER |
| NPI Number: | 1659337822 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | PT013927L |
| Business Practice Address: | 2209 Quarry Dr B 23 Reading, PA - 196091155 |
| Business Phone Number: | 6106789949 |
| Business Fax Number: | 6106789636 |
| Mailing Address: | 2209 Quarry Dr, B-23 READING |
| State: | PA |
| Postal Code: | 196091155 |
| Phone Number: | 6106789949 |
| Fax Number: | 6106789636 |
| NPI Enumeration Date: | 04/25/2006 |
| NPI Last Update Date: | 08/03/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT013927L |
| 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 |