Gary Lee Wagner

NPI 1316190820 - Developmental Therapist - 222Q00000X

NPI Details
NPI 1316190820
Gender Male
Enumeration Date 10/28/2008
Last Updated 10/28/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
897 LILAC RD
BELOIT WI, 53511-1627, US
Phone (608) 290-6705
Fax
Business Location
897 LILAC RD
BELOIT WI, 53511-1627, US
Phone (608) 290-6705
Fax
Toxanomy
Taxonomy Code 222Q00000X
License State
License Number
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According to our database, Gary Lee Wagner NPI is 1316190820, taxonomy code is 222Q00000X Gary Lee Wagner physically located at 897 Lilac Rd, Beloit WI, 53511-1627. NPI Number Gary Lee Wagner has the Individual type.

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1316190820 NPI number is provided on an as is basis without warranty of any kind. 1316190820 is maintained by the National Plan & Provider Enumeration System. The contents of Gary Lee Wagner are for informational purposes only.