Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Kellie Marie Wagner, PT, DPT, CSCS

Individual provider Physical Therapist · NPI 1144539461

Dr. Kellie Marie Wagner, PT, DPT, CSCS is a Physical Therapist in Beaver Dam, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2010.

Licensed in
WI
In the registry since
2010
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

1223 Madison St
Beaver Dam, WI 53916-2629
Phone: (920) 885-4750
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 11507-24 (WI)

Record details

NPI number1144539461
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT , DPT , CSCS
Sole proprietorNo
NPI enumeratedOctober 4, 2010
Last updated in NPPESOctober 4, 2010

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