Individual
MS. KAYCE LEAH WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
800 UNIVERSITY WAY, SPARTANBURG, SC 29303-4932
(864) 503-5046
Mailing address
902 E LEE RD, TAYLORS, SC 29687-3260
(716) 969-0906
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1484
SC
Other
Enumeration date
06/23/2013
Last updated
07/21/2022
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