DIANE JORDAN-WAGNER

TERRE HAUTE, IN
NPI1013025097
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207RA0201X Internal Medicine, Allergy & Immunology
(Licence: IN  01056292A)
Additional Taxonomies207RA0201X Internal Medicine, Allergy & Immunology
(Licence: IL  36106006)
Enumeration Date2006-08-29
Last Update Date2013-03-14
Business Address
-- DIANE JORDAN-WAGNER M.D.
1429 N 6TH ST
TERRE HAUTE, IN 47804-1037
Phone number: 812-232-0564
Mailing Address
-- DIANE JORDAN-WAGNER M.D.
221 S 6TH ST
TERRE HAUTE, IN 47807-4214
Phone number: 812-232-0564