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:
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Health care specialties

SpecialtyCodeLicense #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 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174503817 NPPES
Wisconsin MEDICAID 40054800

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