Joshua James Wageman, PA-C, DPT, CSCS Valid NPI

Individual provider · Physician Assistant · Eagle, ID

NPI

1770925257

Type

Individual (Type 1)

Primary specialty

Physician Assistant

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363A00000X

License number

PA-1896 (ID)

Sex

Male

Sole proprietor

No

Enumerated

2013-07-24

Last updated

2021-03-09