Individual
EMMA CHRISTINE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
4400 SW 20TH AVE APT 3203, GAINESVILLE, FL 32607-3902
(215) 262-5244
Mailing address
4400 SW 20TH AVE APT 3203, GAINESVILLE, FL 32607-3902
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL5284
FL
Other
Enumeration date
07/22/2018
Last updated
07/22/2018
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