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1104598895
KYLE ALEXANDER WAGNER
FORT CAMPBELL, KY
NPI
1104598895
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2021-09-30
Last Update Date
2022-11-04
Business Address
KYLE ALEXANDER WAGNER PA-C
650 JOEL DR
FORT CAMPBELL, KY 42223-5318
Phone number: 805-206-8883
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Mailing Address
KYLE ALEXANDER WAGNER PA-C
650 JOEL DR
FORT CAMPBELL, KY 42223-5318
Phone number:
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