Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LESA WAGNER, MTD
Active Sole ProprietorAthletic Trainer · NEWPORT, OR
Registration Details
- NPI Number
- 1447827407
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 8, 2021 (4.8714547625367 yrs)
- Last Updated
- Jun 8, 2021
- Sole Proprietor
- Yes
Practice Information
- Address
-
36 SW NYE STNEWPORT, OR, 973653821Browse OR providers · Browse ZIP 97365
- Phone
- 5412650445
- Fax
- 8447600526
- Primary Specialty
-
Athletic Trainer
225500000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.