IndividualActive
Kimberly Wagner, DPT
NPI 1104176593 · Pediatric Physical Therapist · Henderson, NV
Provider details
- NPI number
- 1104176593
- Entity type
- Individual
- Primary specialty
- Pediatric Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- DPT
- Sex
- Female
- Sole proprietor
- No
- License
- 2757 (NV)
Practice location
750 Coronado Center Dr
Suite 120
Henderson, NV 89052-5034
Phone: (702) 564-4116
Mailing address
6617 Sunset Pines St
Las Vegas, NV 89148-4251
Registry dates
- Enumerated
- 2012-09-13
- Last updated
- 2019-09-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.