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1386852937
TERRY J WAGNER
EVERETT, WA
NPI
1386852937
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: WA MA00018843)
Enumeration Date
2007-05-18
Last Update Date
2007-07-08
Business Address
Mr. TERRY J WAGNER LMP
2615 W CASINO RD SUITE 1A
EVERETT, WA 98204-2124
Phone number: 425-348-4649
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Mailing Address
Mr. TERRY J WAGNER LMP
PO BOX 673
MOUNTLAKE TERRACE, WA 98043-0673
Phone number: 425-348-4649
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