Individual provider · Type 1 NPI

Bethany Wagenbach, PTA

Physical Therapy Assistant · Peoria, IL

NPI number 1801460266 Active

Practice location

6809 N Knoxville Ave
Peoria, IL 61614-2812

Mailing address

507 S Warren St
Tremont, IL 61568-8565

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000X160.009110 (IL)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1801460266

Bethany Wagenbach, PTA's National Provider Identifier is 1801460266, issued on May 19, 2021. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Peoria, IL. The record was last updated on May 19, 2021.