Individual
SAMANTHA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
2960 N CIRCLE DR STE 200, COLORADO SPRINGS, CO 80909-1163
(719) 634-8891
Mailing address
2960 N CIRCLE DR STE 200, COLORADO SPRINGS, CO 80909-1163
(719) 634-8891
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86289910
CO
Other
Enumeration date
12/20/2022
Last updated
12/20/2022
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