MICHAEL C WAGNER

DANVILLE, IL
NPI1073655825
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IL  209003483)
Enumeration Date2007-02-12
Last Update Date2010-11-17
Business Address
-- MICHAEL C WAGNER FNP
603 N LOGAN AVE
DANVILLE, IL 61832-4320
Phone number: 217-213-5254
Mailing Address
-- MICHAEL C WAGNER FNP
603 N LOGAN AVE
DANVILLE, IL 61832-4320
Phone number: 217-213-5254
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