Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bethany Wagenbach, PTA

Individual provider Physical Therapy Assistant · NPI 1801460266

Bethany Wagenbach, PTA is a Physical Therapy Assistant in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2021.

Licensed in
IL
In the registry since
2021
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

6809 N Knoxville Ave
Peoria, IL 61614-2812
Phone: (309) 981-8810
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 160.009110 (IL)

Record details

NPI number1801460266
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedMay 19, 2021
Last updated in NPPESMay 19, 2021
Certification dateMay 19, 2021
Mailing address507 S Warren St, Tremont, IL 61568-8565

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