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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

TANNER KEITH WAGNER

Active

TANNER KEITH WAGNER is a Occupational Therapist healthcare provider located in GRUNDY, Virginia. NPI 1043032154 is currently active in the NPPES registry. Verify at CMS.

Occupational Therapist · GRUNDY, VA

Registration Details

NPI Number
1043032154
Provider Type
Individual
Gender
Male
NPI Issued
Oct 29, 2024 (1.797297844458 yrs)
Last Updated
Oct 29, 2024
License
0119010676 (VA)

Practice Information

Address
20716 RIVERSIDE DR
GRUNDY, VA, 246146747
Browse VA providers · Browse ZIP 24614
Phone
2769356496
Primary Specialty
Occupational Therapist
225X00000X

Other Occupational Therapist Providers in GRUNDY, VA

Name Credential NPI
MEGAN HALL 1184204331
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.