Michael Keith Wangerin

NPI #1710447875 in Wildwood, Missouri

Provider Information

NPI Number: 1710447875
Entity Type: Individual
Name: Michael Keith Wangerin
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Mar 23, 2019
Last Updated: Mar 23, 2019

Practice Location

Address: 16250 AUDUBON VILLAGE DR
City: Wildwood
State: Missouri
ZIP Code: 63040-1708
Phone: (636) 489-9185

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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