Jake Wagner
Jake Wagner is a Student in an Organized Health Care Education/Training Program in Louisville, Kentucky. Registered with an NPI since 2022.
- In the registry since
- 2022
Practice location Address checks out
550 S Jackson St # A3K00Louisville, KY 40202-1622
Phone: (502) 852-4277
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|
Record details
| NPI number | 1114667334 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | March 29, 2022 |
| Last updated in NPPES | March 29, 2022 |
| Certification date | March 29, 2022 |
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