Individual
MADISON KATE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3101 PARISA DR, PADUCAH, KY 42003-4584
(270) 444-8477
Mailing address
409 CASTLETON PIKE, PADUCAH, KY 42003-1246
(270) 994-4018
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
KY
Other
Enumeration date
05/30/2023
Last updated
05/30/2023
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