Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dietrich B Wagner, ATC

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1083392419

Dietrich B Wagner, ATC is a Student in an Organized Health Care Education/Training Program in Cedar Falls, Iowa. Licensed in Iowa. Registered with an NPI since 2023.

Licensed in
IA
In the registry since
2023
Specialties on file
3
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

1505 Springbrook Dr
Cedar Falls, IA 50613-4994
Phone: (515) 664-0171
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X (IA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (IA)

Record details

NPI number1083392419
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC
Sole proprietorNo
NPI enumeratedJuly 6, 2023
Last updated in NPPESMay 23, 2025
Certification dateMay 23, 2025

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