Wagner, Brad

Wagner, Brad is an individual health care provider with primary practice located at 4706 Aero Pkwy , Florence KY 41042-2994. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Wagner, Brad can be contacted via phone (513) 431-9305.

Contact Information

Primary practice address
4706 Aero Pkwy Florence KY 41042-2994
Phone: (513) 431-9305
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X AT1725 Kentucky

Profile Details

NPI number 1457985053
LBN Legal business name Wagner, Brad
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2020
Last updated Feb 24th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457985053 NPPES
Kentucky Other AT1725 KENTUCKY BOARD OF MEDICAL LICENSURE

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