Wagner, Carolyn
Wagner, Carolyn is an sole proprietor health care provider with primary practice located at 1130 N Westfield St , Oshkosh WI 54902-3217. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Wagner, Carolyn can be contacted via phone (920) 237-2163.Contact Information
Primary practice address
1130 N Westfield St
Oshkosh WI 54902-3217
Phone: (920) 237-2163
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant | 225200000X | 1176-19 | Wisconsin |
Profile Details
| NPI number | 1306002506 |
|---|---|
| LBN Legal business name | Wagner, Carolyn |
| Credentials | Physical Therapist Assistant (PTA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 6th, 2008 |
| Last updated | Aug 6th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306002506 | NPPES |
| Wisconsin | MEDICAID | 40460700 |
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