Individual
ALLISON WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 VAIRO BLVD, APT 1411C, STATE COLLEGE, PA 16803-2653
(443) 944-7535
Mailing address
501 VAIRO BLVD, APT 1411C, STATE COLLEGE, PA 16803-2653
(443) 944-7535
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
PA
Other
Enumeration date
04/25/2016
Last updated
04/25/2016
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