Charles Tom Wagner, PT
NPI #1891858809 in Twin Falls, Idaho
Provider Information
- NPI Number
- 1891858809
- Entity Type
- Individual
- Name
- Charles Tom Wagner, PT
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physical Therapist
- Credential
- PT
- Enumeration Date
- Dec 19, 2006
- Last Updated
- Apr 5, 2013
Practice Location
- Address
- 754 N COLLEGE RD
- Address 2
- STE D
- City
- Twin Falls
- State
- Idaho
- ZIP Code
- 83301-5822
- Phone
- (208) 734-5313
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
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