Michelle Renae Wagoner, PT, DPT

NPI #1003141433 in Peoria, Arizona

Provider Information

NPI Number: 1003141433
Entity Type: Individual
Name: Michelle Renae Wagoner, PT, DPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT, DPT
Enumeration Date: Oct 2, 2009
Last Updated: Oct 2, 2009

Practice Location

Address: 9713 W TONOPAH DR
City: Peoria
State: Arizona
ZIP Code: 85382-5110
Phone: (480) 381-0220

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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