ETHAN E WAGNER

ANDERSON, IN
NPI1386643310
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: IN  02002898A)
Enumeration Date2005-07-20
Last Update Date2007-10-10
Business Address
Dr. ETHAN E WAGNER DO
2015 JACKSON ST
ANDERSON, IN 46016-4337
Phone number: 765-646-8439
Mailing Address
Dr. ETHAN E WAGNER DO
2015 JACKSON ST
ANDERSON, IN 46016-4337
Phone number: 765-646-8439
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