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

Tanner Keith Wagner

Individual provider Occupational Therapist · NPI 1043032154

Tanner Keith Wagner is an Occupational Therapist in Grundy, Virginia. Licensed in Virginia. Registered with an NPI since 2024.

Licensed in
VA
In the registry since
2024

Practice location Address checks out

20716 Riverside Dr
Grundy, VA 24614-6747
Phone: (276) 935-6496
Show map & directions

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

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 0119010676 (VA)

Record details

NPI number1043032154
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 29, 2024
Last updated in NPPESOctober 29, 2024
Certification dateOctober 29, 2024
Mailing address20716 Riverside Dr, Grundy, VA 24614-6747

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