Individual
AVERY SOFIA WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
PO BOX 494, CAMPBELLTOWN, PA 17010-0494
(717) 838-2600
Mailing address
PO BOX 494, CAMPBELLTOWN, PA 17010-0494
(717) 740-0080
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG016108
PA
Other
Enumeration date
02/06/2025
Last updated
03/10/2025
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