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

BLAKE DOUGLAS WAGNER, PT

Active

BLAKE DOUGLAS WAGNER, PT is a Physical Therapy Assistant healthcare provider located in FREMONT, Nebraska. NPI 1811057664 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · FREMONT, NE

Registration Details

NPI Number
1811057664
Provider Type
Individual
Gender
Male
NPI Issued
Dec 11, 2006 (19.67749418845 yrs)
Last Updated
Oct 30, 2023
Licenses
01883 (IA)
1004 (NE)

Practice Information

Address
410 E 22ND ST STE 2
FREMONT, NE, 680252640
Browse NE providers · Browse ZIP 68025
Phone
8009744378
Fax
6305151536
Primary Specialty
Physical Therapy Assistant
225100000X
Additional Specialty
Physical Therapy Assistant

Other Physical Therapy Assistant Providers in FREMONT, NE

Name Credential NPI
MARY JANE THEILER MPT 1497737712
PHILIP DARREN DAVIDSON MPT 1679555999
MR. TROY T POST IX P.T. 1801848072
FRED W. BROWN PT 1598707507
ROSS M TESSENDORF DPT 1073539987
CHRIS M DEMUTH DPT 1871519785
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.