Individual ProviderColleen M WagarPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address16455 Statesville Rd, Suite 300, Huntersville, NC 28078-7135(704) 801-3719(704) 674-9346PECOS EnrollmentBased on the most recent information from CMS, provider Colleen M Wagar does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:51 AM.Profile DetailsProvider ID1386659902Provider TypeIndividualFull NameWagar, Colleen MCredentialPTGenderFemaleSole ProprietorNoEnumeration Date7/30/2006Last Updated9/10/2009Contact InformationPractice LocationPractice Address16455 Statesville Rd, Suite 300, Huntersville, NC 28078-7135Phone(704) 801-3719Fax(704) 801-3705Mailing LocationMailing Address1691 Old Harmony Dr NW, Concord, NC 28027-8031Phone(704) 674-9346FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense8451North CarolinaProvider IdentifiersIDDescriptionIssuerID7211860DescriptionMedicaidIssuerUnlistedNorth CarolinaIDE1251DescriptionOtherIssuerMEDCOST NCNorth CarolinaID079PUDescriptionOtherIssuerBCBS NCNorth Carolina