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1063018802
TERESA GAIL WAGNER
SUTTON, WV
NPI
1063018802
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
376J00000X Homemaker
Enumeration Date
2020-12-08
Last Update Date
2020-12-08
Business Address
TERESA GAIL WAGNER
101 2ND ST STE 201
SUTTON, WV 26601-1303
Phone number: 304-765-3668
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Mailing Address
TERESA GAIL WAGNER
620 DOTSON CT APT 23
SUMMERSVILLE, WV 26651-1767
Phone number: 304-880-0996
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