Most Relevant Information
Provider Data
| NPI Number: | 1003224478 |
| Provider Name: | BETH WAGNER PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | PTA-09596 |
Most Important Dates
| Enumeration Date: | 07/29/2014 |
| Last Updated: | 07/29/2014 |
Provider Practice Location
4645 BELPAR ST NW
CANTON
OH
447183602
Practice Location Phone/Fax
| Phone: | 3304934210 |
| Fax: | 3304934744 |
Provider Mailing Location
4645 BELPAR ST NW
CANTON
OH
447183602
Provider Mailing Phone/Fax
| Phone: | 3304934210 |
| Fax: | 3304934744 |