Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251N0400X | Physical Therapist - Neurology | ||
Y | 2251P0200X | Physical Therapist - Pediatrics | ||
N | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1093283426 |
---|---|
Provider Name | Mrs. Sarah Wager |
First Address | Long Beach, CA 90803-1630 |
Second Address | Long Beach, CA 90804-2182 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2018 |
Last Update Date | 03/11/2018 |