MEDICARE: MRS. JODI LYNN WAGNER OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	3368-026	WI

General Provider Information

NPI Number	:	1295947778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JODI LYNN WAGNER OTR

Provider Business Mailing Address
First Line	:	20 SOUTH STREET
Second Line	:
City	:	PLYMOUTH
State	:	WI
Zip	:	53073-2420
Country	:	US
Telephone Number	:	920-893-8222
Fax Number	:

Provider Business Practice Location Address
First Line	:	2629 NORTH 7TH STREET
Second Line	:
City	:	SHEBOYGAN
State	:	WI
Zip	:	53083
Country	:	US
Telephone Number	:	920-451-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1831197425 — SHEBOYGAN SENIOR COMMUNITY, INC.
Practice Location Address:

3505 CTY RD. Y
SHEBOYGAN, WI
53083-2400

Practice Phone: 920-458-2137
Practice Fax: 920-458-5922

1285628172 — SHERYL LINDMAN OD
Practice Location Address:

2644 N 8TH ST
SHEBOYGAN, WI
53083-4921

Practice Phone: 920-458-3312
Practice Fax: 920-458-6827

1396720900 — BRIAN L MUEHLBAUER PT
Practice Location Address:

2629 N 7TH ST
SHEBOYGAN, WI
53083-4932

Practice Phone: 920-451-5634
Practice Fax: 920-451-5664

1871542092 — P PERRY PHILLIPS MD
Practice Location Address:

2629 N 7TH ST
SHEBOYGAN, WI
53083-4932

Practice Phone: 920-451-5000
Practice Fax:

1770521486 — JOCELYN A ACOMPANADO PA-C
Practice Location Address:

2629 N 7TH ST
SHEBOYGAN, WI
53083-4932

Practice Phone: 920-451-5000
Practice Fax: 920-451-5333

1487682696 — JOHN R BOARDMAN MD
Practice Location Address:

2629 N 7TH ST
SHEBOYGAN, WI
53083-4932

Practice Phone: 920-451-5553
Practice Fax: 920-451-5113

1417981630 — AURORA PHARMACY INC
Practice Location Address:

2927 N 15TH ST , SUITE 100
SHEBOYGAN, WI
53083-3946

Practice Phone: 920-458-4348
Practice Fax: 920-451-8307

Directions to “ MRS. JODI LYNN WAGNER OTR” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.