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General NPI Number Information
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NPI Number | 1558555326
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Entity Type | Organization
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Legal Business Name | NAPOLEON PHYSICAL THERAPY AND SPORTS MEDICINE LLC
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Dates
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Enumeration Date | 09/05/2007
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Last Update Date | 03/05/2014
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Provider Practice Location Address
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Address Line | 1322 WOODLAWN AVE SUITE 1
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City | NAPOLEON
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State | OH
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Zip | 43545-1178
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Country | US
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Telephone | 419-599-0888
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Fax | 419-599-0087
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Provider Business Mailing Address
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Address Line | 1322 WOODLAWN AVE SUITE 1
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City | NAPOLEON
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State | OH
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Zip | 43545-1178
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Country | US
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Telephone | 419-599-0888
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Fax | 419-599-0087
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Authorized Official
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Title or Position | PT/OWNER
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Name | MR. JEFFERY BUDD WAGNER
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Credential | PT
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Telephone | 419-599-0888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 9959
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License Number State | OH
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