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1356922959
JACOB LEWIS WAGNER
DANVILLE, PA
NPI
1356922959
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-04-16
Last Update Date
2021-04-27
Business Address
Dr. JACOB LEWIS WAGNER DO
100 N ACADEMY AVE # 61-22
DANVILLE, PA 17822-9800
Phone number: 570-416-1925
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Mailing Address
Dr. JACOB LEWIS WAGNER DO
100 N ACADEMY AVE # 61-22
DANVILLE, PA 17822-9800
Phone number: 570-416-1925
Copy
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