VAN L WAGNER

SAINT LOUIS, MO
NPI1316028186
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208600000X Surgery
(Licence: MO  2003009179)
Enumeration Date2006-10-18
Last Update Date2012-08-21
Business Address
-- VAN L WAGNER MD
10007 KENNERLY ROAD SUITE A
SAINT LOUIS, MO 63128-2179
Phone number: 314-776-7112
Mailing Address
-- VAN L WAGNER MD
PO BOX 29255
SAINT LOUIS, MO 63126-0255
Phone number: 314-776-7112
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