MICHAEL CHARLES WAGNER

NAMPA, ID
NPI1235585191
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225X00000X Occupational Therapist
(Licence: ID  OT-1598)
Enumeration Date2016-05-10
Last Update Date2016-05-10
Business Address
-- MICHAEL CHARLES WAGNER
170 2ND ST S
NAMPA, ID 83651-3708
Phone number: 208-385-3651
Mailing Address
-- MICHAEL CHARLES WAGNER
170 2ND ST S
NAMPA, ID 83651-3708
Phone number: 208-385-3651
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