Individual
PATRICK WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
409 11TH AVE W, HUNTINGTON, WV 25701-3029
(304) 617-5403
Mailing address
409 11TH AVE W, HUNTINGTON, WV 25701-3029
(304) 617-5403
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/10/2021
Last updated
10/10/2021
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