Individual
NATHAN WAGENET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3020 YORBA LINDA BLVD APT C24, FULLERTON, CA 92831-2344
(714) 225-8919
Mailing address
3020 YORBA LINDA BLVD APT C24, FULLERTON, CA 92831-2344
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
97300
CA
Other
Enumeration date
01/23/2025
Last updated
01/23/2025
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