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

Judith Wagner

Individual provider Physical Therapist · NPI 1659458016

Judith Wagner is a Physical Therapist in Private Practice in Saint Clair Shores, Michigan. Qualified in 1983, 43 years ago. Practices with Leelanau Physical Therapy PC, a 16-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
43
Licensed in
MI
In the registry since
2006

Practice location Address checks out

23161 Greater Mack Ave
Saint Clair Shores, MI 48080-1956
Phone: (586) 779-8892
Fax: (586) 779-2869
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 5501002691 (MI)

Record details

NPI number1659458016
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedNovember 1, 2006
Last updated in NPPESJuly 8, 2007
Mailing address23161 Greater Mack Ave, Saint Clair Shores, MI 48080-1956

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1983 (43 years in practice)
Group practice Leelanau Physical Therapy Pc — 16 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Saint Clair Shores