Ty'ara Wagner, is a
Massage Therapist based in Linwood, North Carolina. Ty'ara Wagner is licensed to practice in North Carolina (license number 17320) and her current practice location is
100 Columbia Dr, Linwood, North Carolina. She can be reached at her office (for appointments etc.) via phone at
(980) 267-2965.
NPI number for Ty'ara Wagner is 1588250351 and her current mailing address is 4732 Lebanon Rd Ste D, Mint Hill, North Carolina. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1588250351.
Healthcare Provider's Profile
Full Name | Ty'ara Wagner |
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Gender | Female |
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Speciality | Massage Therapist |
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Location | 100 Columbia Dr, Linwood, North Carolina |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1588250351
- Provider Enumeration Date: 12/16/2020
- Last Update Date: 07/29/2024
Medical Identifiers
Medical identifiers for Ty'ara Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1588250351 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225700000X | Massage Therapist | 17320 (North Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ty'ara Wagner is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Ty'ara Wagner, 4732 Lebanon Rd Ste D, Mint Hill, NC 28227-9112 Ph: (704) 763-2059 | Ty'ara Wagner, 100 Columbia Dr, Linwood, NC 27299-9711 Ph: (980) 267-2965 |
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