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1023673878
COURTNEY LYNN WAGNER
APPLETON, WI
NPI
1023673878
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WI 1890-39)
Enumeration Date
2019-05-07
Last Update Date
2024-10-13
Business Address
COURTNEY LYNN WAGNER LAT, ATC
2105 E ENTERPRISE AVE # 113
APPLETON, WI 54913-7862
Phone number: 920-991-2561
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Mailing Address
COURTNEY LYNN WAGNER LAT, ATC
N7898 LAKESHORE DR
FOND DU LAC, WI 54937-1647
Phone number: 920-517-6961
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