Individual
NOLAN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
1970 S RIDGE RD, GREEN BAY, WI 54304-4125
(920) 430-4888
Mailing address
6700 COUNTY ROAD J, STURGEON BAY, WI 54235-9336
(920) 495-3052
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2289-39
WI
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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