Individual
HOLLISTON WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, MS
Contact information
Practice address
4704B W MONTGOMERY AVE, TAMPA, FL 33616-1042
(813) 307-8071
Mailing address
8703 TAHITI LN, TAMPA, FL 33615-4427
(813) 928-8808
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
10/25/2024
Last updated
10/25/2024
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