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

Mr. Kevin Matthew Wagner, MDPTCERTMDT

Individual provider Physical Therapist · NPI 1295735926

Mr. Kevin Matthew Wagner, MDPTCERTMDT is a Physical Therapist in Bridgeton, Missouri. Licensed in Missouri. Registered with an NPI since 2005.

Licensed in
MO
In the registry since
2005

Practice location Address checks out

11903 Saint Charles Rock Rd
Bridgeton, MO 63044-2623
Phone: (314) 770-0900
Fax: (314) 770-1673
Show map & directions

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 115026 (MO)

Record details

NPI number1295735926
Entity typeIndividual (Type 1)
GenderMale
Credentials MDPTCERTMDT
Sole proprietorNo
NPI enumeratedJuly 22, 2005
Last updated in NPPESApril 29, 2010

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