Individual
ELIZABETH H. WAGNER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MS, ATC,LAT
Contact information
Practice address
100 CHAMPIONS PL, EL PASO, TX 79912-3725
(915) 834-2465
(915) 587-6458
Mailing address
100 CHAMPIONS PL, EL PASO, TX 79912
(915) 834-2465
(915) 587-6458
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0963
TX
Other
Enumeration date
02/22/2006
Last updated
07/08/2007
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