Doctor Name: | MR. RICK WAGELIE |
NPI Number: | 1942200936 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | OTR/L |
License Number: | # 421 |
Business Practice Address: | 5156 S 197th Avenue Cir Omaha, NE - 681353679 |
Business Phone Number: | 4022900931 |
Business Fax Number: | 4025970382 |
Mailing Address: | 5156 S 197th Avenue Cir, OMAHA |
State: | NE |
Postal Code: | 681353679 |
Phone Number: | 4022900931 |
Fax Number: | 4025970382 |
NPI Enumeration Date: | 07/30/2005 |
NPI Last Update Date: | 03/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | # 421 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |