Individual provider · Type 1 NPI

Jordan Wagner

Pediatric Physical Therapist · Virginia Beach, VA

NPI number 1548145402 Active

Practice location

1400 Fordham Dr
Virginia Beach, VA 23464-5368

Call (757) 361-3951 Map

Mailing address

1701 While Ln
Norfolk, VA 23518-4821

Specialties and licenses

TaxonomyCodeLicense
Pediatric Physical Therapist Primary 2251P0200X2305217318 (VA)

Pediatric Physical Therapist: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical th…

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About NPI 1548145402

Jordan Wagner's National Provider Identifier is 1548145402, issued on Aug 9, 2025. The primary taxonomy on file is Pediatric Physical Therapist (2251P0200X), and the practice location is in Virginia Beach, VA. The record was last updated on Aug 13, 2025.