Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. KEVIN MATTHEW WAGNER, MD PT CERT MDT
ActiveMR. KEVIN MATTHEW WAGNER, MD PT CERT MDT is a Physical Therapy Assistant healthcare provider located in BRIDGETON, Missouri. NPI 1295735926 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · BRIDGETON, MO
Registration Details
- NPI Number
- 1295735926
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 22, 2005 (21.023196206189 yrs)
- Last Updated
- Apr 29, 2010
- License
-
115026 (MO)
Practice Information
- Address
-
11903 SAINT CHARLES ROCK RDBRIDGETON, MO, 630442623Browse MO providers · Browse ZIP 63044
- Phone
- 3147700900
- Fax
- 3147701673
- Primary Specialty
-
Physical Therapy Assistant
225100000X
Other Physical Therapy Assistant Providers in BRIDGETON, MO
| Name | Credential | NPI |
|---|---|---|
| MISS LANA DASILVA ALLEN | P.T. | 1679515027 |
| MISS KELLY C HOLSCHEN | PT | 1063423275 |
| PATRICIA ACKERMANN | — | 1093821332 |
| PATIENCE WESTFALL | — | 1932219458 |
| LISE DALY GARGER | PT | 1780794875 |
| RUSTICO MALLILLIN | — | 1487758769 |
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.