Individual
BROOKE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13029 MONROE MANOR DR, OAK HILL, VA 20171-2998
(703) 862-7569
Mailing address
13029 MONROE MANOR DR, OAK HILL, VA 20171-2998
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/02/2024
Last updated
07/09/2024
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