NPI 1083392419

Dietrich B Wagner, ATC

Practitioner Athletic Trainer Cedar Falls, IA

Practice location

Address: 1505 Springbrook Dr, Cedar Falls, IA 50613-4994
Phone: (515) 664-0171
Mailing address: 4133 64th St, Urbandale, IA 50322-2705

Registered specialties (3)

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X

Other Specialist/Technologist providers in Iowa →

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

Other Student in an Organized Health Care Education/Training Program providers in Iowa →

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

Registry record

NPI: 1083392419
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Jul 2023
Record last updated: 23 May 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.