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1053088005
BLAIR WAGNER
SLIDELL, LA
NPI
1053088005
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
343900000X Non-emergency Medical Transport (VAN)
(Licence: LA 009605995)
Enumeration Date
2021-08-26
Last Update Date
2021-08-26
Business Address
BLAIR WAGNER
1501 MAGNOLIA ST # B
SLIDELL, LA 70460-8821
Phone number: 504-400-3896
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Mailing Address
BLAIR WAGNER
1501 MAGNOLIA ST # B
SLIDELL, LA 70460-8821
Phone number:
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