Individual
FEAN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATHLETIC TRAINER
Contact information
Practice address
507 S MAIN ST, VIROQUA, WI 54665-2059
(608) 637-2101
Mailing address
507 S MAIN ST, VIROQUA, WI 54665-2059
(608) 637-2101
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
608-39
WI
Other
Enumeration date
05/21/2021
Last updated
05/21/2021
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