Individual
MR. DANIEL M WAGNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1200 W UNIVERSITY AVE, BOX 912, MITCHELL, SD 57301-4358
(605) 995-2145
(605) 995-2143
Mailing address
1200 W UNIVERSITY AVE, BOX 912, MITCHELL, SD 57301-4358
(605) 995-2145
(605) 995-2143
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0049
SD
Other
Enumeration date
05/11/2006
Last updated
07/08/2007
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