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1578256103
MADISON KATE WAGNER
PADUCAH, KY
NPI
1578256103
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2023-05-30
Last Update Date
2023-05-30
Business Address
MADISON KATE WAGNER
3101 PARISA DR
PADUCAH, KY 42003-4584
Phone number: 270-444-8477
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Mailing Address
MADISON KATE WAGNER
409 CASTLETON PIKE
PADUCAH, KY 42003-1246
Phone number: 270-994-4018
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