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1275583544
CAROLE SUE WAGNER
SAINT LOUIS, MO
NPI
1275583544
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
174400000X Specialist
(Licence: MO 2004012994)
Enumeration Date
2006-05-10
Last Update Date
2007-07-08
Business Address
Ms. CAROLE SUE WAGNER O.T.R./L
1 JEFFERSON BARRACKS DR
SAINT LOUIS, MO 63125-4181
Phone number: 314-894-6505
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Mailing Address
Ms. CAROLE SUE WAGNER O.T.R./L
862 PHEASANT WOODS DR
MANCHESTER, MO 63021-4300
Phone number: 636-394-7429
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