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1124542980
KIMBERLY MARIE WAGNER
ATLANTA, GA
NPI
1124542980
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: GA AT002993)
Enumeration Date
2017-08-02
Last Update Date
2017-08-02
Business Address
KIMBERLY MARIE WAGNER AT
59 EXECUTIVE PARK S STE 1100
ATLANTA, GA 30329-2208
Phone number: 404-778-6330
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Mailing Address
KIMBERLY MARIE WAGNER AT
8259 WICKER AVE
SAINT JOHN, IN 46373-8878
Phone number: 219-635-6560
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