NICHOLAAS COLLIN WAGNER

FORT CAMPBELL, KY
NPI1245065846
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2024-09-04
Last Update Date2024-09-04
Business Address
NICHOLAAS COLLIN WAGNER PA-S
650 JOEL DR
FORT CAMPBELL, KY 42223-5318
Phone number: 210-620-0085
Mailing Address
NICHOLAAS COLLIN WAGNER PA-S
492 AYDEN LN
CLARKSVILLE, TN 37042-2887
Phone number: 210-620-0085