Individual
BEN WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
840 E 37TH ST, AUSTIN, TX 78705-1806
(512) 751-4335
Mailing address
840 E 37TH ST, AUSTIN, TX 78705-1806
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/16/2019
Last updated
08/16/2019
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