Garth Wagenman, PT

NPI #1952599284 in Flagstaff, Arizona

Provider Information

NPI Number: 1952599284
Entity Type: Individual
Name: Garth Wagenman, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: PT
Enumeration Date: Oct 11, 2007
Last Updated: Oct 11, 2007

Practice Location

Address: 125 E ELM AVE
Address 2: STE 103
City: Flagstaff
State: Arizona
ZIP Code: 86001-3258
Phone: (928) 779-1679

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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