person
Maddie A Wagoner, ATS
Student in an Organized Health Care Education/Training Program in Pocatello, Idaho
NPI 1871200766

Maddie A Wagoner is a Student in an Organized Health Care Education/Training Program based in Pocatello, ID. Maddie A Wagoner practices in Pocatello, ID and has the professional credentials of ATS. The NPI Number for Maddie A Wagoner is 1871200766 and holds a License No. (Idaho).

The current practice location address for Maddie A Wagoner is 1110 E Halliday St, Pocatello, ID and can be reached out via phone at 208-851-8361.

Location: 1110 E Halliday St, Pocatello, ID, 83201-4824
person
Provider Profile Details
NPI Number
1871200766
Provider Name
Maddie A Wagoner
Credential
ATS
Provider Entity Type
Individual
Gender
Female
Address
1110 E Halliday St, Pocatello, ID, 83201-4824
Phone Number
208-851-8361
Fax Number
Provider Enumeration Date
11/01/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1110 E Halliday St
City
State
Zip
83201-4824
Phone Number
208-851-8361
Fax Number
person
Provider Business Mailing Address Details
Address
1110 E Halliday St
City
State
Zip
83201-4824
Phone Number
208-851-8361
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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