Wagner, Susan
Wagner, Susan is an individual health care provider with primary practice located at 1400 Bellinger St , Eau Claire WI 54703-5222. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Wagner, Susan can be contacted via phone (715) 838-5222.Contact Information
Primary practice address
1400 Bellinger St
Eau Claire WI 54703-5222
Phone: (715) 838-5222
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 1798 | Wisconsin |
Profile Details
| NPI number | 1174503817 |
|---|---|
| LBN Legal business name | Wagner, Susan |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 19th, 2006 |
| Last updated | May 4th, 2009 - about 16 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 | 1174503817 | NPPES |
| Wisconsin | MEDICAID | 40054800 |
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