Max Wagonheim, PTA

NPI #1760854095 in Lutherville, Maryland

Provider Information

NPI Number: 1760854095
Entity Type: Individual
Name: Max Wagonheim, PTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Oct 26, 2015
Last Updated: Oct 26, 2015

Practice Location

Address: 515 BRIGHTFIELD RD
City: Lutherville
State: Maryland
ZIP Code: 21093-3643
Phone: (410) 296-1990

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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