Wagoner, Maddie A

Wagoner, Maddie A is an individual health care provider with primary practice located at 1040 Gulf Breeze Pkwy Ste 203 , Gulf Breeze FL 32561-7808. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer is her primary health care specialty. Wagoner, Maddie A can be contacted via phone (208) 851-8361.

Contact Information

Primary practice address
1040 Gulf Breeze Pkwy Ste 203 Gulf Breeze FL 32561-7808
Phone: (208) 851-8361
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 7019 Florida

Profile Details

NPI number 1871200766
LBN Legal business name Wagoner, Maddie A
Credentials ATS
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2022
Last updated Jul 10th, 2024 - about 2 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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