Individual provider · Type 1 NPI

Blair Ellen Wagoner

Pediatric Physical Therapist · Lexington, KY

NPI number 1891939344 Active

Practice location

1001 Monarch St, Suite 110
Lexington, KY 40513-1495

Call (859) 224-0834 Map

Mailing address

115 West Dr
Murray, KY 42071-9830

Specialties and licenses

TaxonomyCodeLicense
Physical Therapist 225100000XPT 3141 (AR)
Pediatric Physical Therapist Primary 2251P0200XPT005412 (KY)

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 1891939344

Blair Ellen Wagoner's National Provider Identifier is 1891939344, issued on Apr 28, 2009. The primary taxonomy on file is Pediatric Physical Therapist (2251P0200X), and the practice location is in Lexington, KY. The record was last updated on Apr 9, 2010.