Individual
TRACEY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
112 N 7TH ST, CHAMBERSBURG, PA 17201-1720
(717) 267-7903
Mailing address
112 N 7TH ST, CHAMBERSBURG, PA 17201-1720
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN007052
PA
Other
Enumeration date
03/18/2022
Last updated
03/18/2022
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