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1316594674
KAYLEIGH WAGNER
ERIE, PA
NPI
1316594674
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2083S0010X Preventive Medicine, Sports Medicine
(Licence: PA RT006112)
Enumeration Date
2019-08-21
Last Update Date
2019-08-21
Business Address
KAYLEIGH WAGNER LAT, ATC
501 W 12TH ST
ERIE, PA 16501-1536
Phone number: 814-455-3719
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Mailing Address
KAYLEIGH WAGNER LAT, ATC
1443 GREENFIELD DR
ERIE, PA 16509-2912
Phone number: 814-602-9206
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