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1104382936
ASHLEY CHRISTINE WAGNER
AUSTIN, TX
NPI
1104382936
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2083S0010X Preventive Medicine, Sports Medicine
(Licence: TX AT5055)
Enumeration Date
2019-02-18
Last Update Date
2019-02-18
Business Address
ASHLEY CHRISTINE WAGNER
3724 EXECUTIVE CENTER DR STE G10
AUSTIN, TX 78731-1665
Phone number: 512-324-9720
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Mailing Address
ASHLEY CHRISTINE WAGNER
428 LEWISVILLE LN
LEANDER, TX 78641-4046
Phone number: 361-500-2803
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