NPI 1316594674

Kayleigh Wagner, LATATC

Practitioner Sports Medicine (Preventive Medicine) Physician Erie, PA

Practice location

Address: 501 W 12th St, Erie, PA 16501-1536
Phone: (814) 455-3719
Mailing address: 1443 Greenfield Dr, Erie, PA 16509-2912

Registered specialties

Sports Medicine (Preventive Medicine) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2083S0010X Licence RT006112 (PA)

Other Preventive Medicine providers in Pennsylvania →

Registry record

NPI: 1316594674
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 Aug 2019
Record last updated: 21 Aug 2019

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.