| NPI | 1194076349 |
|---|---|
| Doing Business As | WAGNER EAR, NOSE & THROAT |
| Entity Type | Organization |
| Authorized Contact | DAVID VAN WAGNER Physician 712-234-8787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2012-11-05 |