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Individual

MS. GRETCHEN MARIE WAGNITZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LAT, ATC

Contact information

Practice address
108 N 40TH ST, PHOENIX, AZ 85034-1704
(602) 286-8904
Mailing address
108 N 40TH ST, PHOENIX, AZ 85034-1704

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0861
AZ

Other

Enumeration date
07/30/2018
Last updated
07/30/2018
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