Wagner, Nicholas Mark
Wagner, Nicholas Mark is an individual health care provider with primary practice located at 600 S Mckinley St Suite 210, Little Rock AR 72205-5202. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Wagner, Nicholas Mark can be contacted via phone (501) 225-0181.Contact Information
Primary practice address
600 S Mckinley St Suite 210
Little Rock AR 72205-5202
Phone: (501) 225-0181
Fax: (501) 225-0384
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT2846 | Arkansas |
Profile Details
| NPI number | 1386685360 |
|---|---|
| LBN Legal business name | Wagner, Nicholas Mark |
| Credentials | DPT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2006 |
| Last updated | Jun 17th, 2014 - about 11 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 | 1386685360 | NPPES |
| Arkansas | Other | 5Y867 | ABCBS |
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