BRYAN WAGNER

JACKSONVILLE, FL
NPI1871016295
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: FL  AL4839)
Enumeration Date2017-07-18
Last Update Date2017-07-18
Business Address
Mr. BRYAN WAGNER ATC, LAT
1045 RIVERSIDE AVE 190
JACKSONVILLE, FL 32201
Phone number: 904-647-4284
Mailing Address
Mr. BRYAN WAGNER ATC, LAT
1045 RIVERSIDE AVE 190
JACKSONVILLE, FL 32204
Phone number:
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