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1346995008
JERRY MAIN WAGNER
UNION MILLS, NC
NPI
1346995008
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NC C018630)
Enumeration Date
2022-02-21
Last Update Date
2025-06-25
Business Address
JERRY MAIN WAGNER
1494 CAMP CREEK RD
UNION MILLS, NC 28167-7900
Phone number: 828-423-6886
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Mailing Address
JERRY MAIN WAGNER
1494 CAMP CREEK RD
UNION MILLS, NC 28167-7900
Phone number: 828-423-6024
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