Individual
DR. RONALD W WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
250 UNIVERSITY AVE, CALIFORNIA, PA 15419-1341
(724) 938-4562
Mailing address
102 SUNRISE DR, PITTSBURGH, PA 15236-3752
(412) 853-1906
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT003718
PA
Other
Enumeration date
10/28/2006
Last updated
07/08/2007
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