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1912957713
DANIEL M WAGNER
MITCHELL, SD
NPI
1912957713
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: SD 0049)
Enumeration Date
2006-05-11
Last Update Date
2007-07-08
Business Address
Mr. DANIEL M WAGNER ATC
1200 W UNIVERSITY AVE BOX 912
MITCHELL, SD 57301-4358
Phone number: 605-995-2145
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Mailing Address
Mr. DANIEL M WAGNER ATC
1200 W UNIVERSITY AVE BOX 912
MITCHELL, SD 57301-4358
Phone number: 605-995-2145
Copy
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