STACY MARIE WAGNER

DES MOINES, IA
NPI1396949129
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy208000000X Pediatrics
(Licence: IA  R-8118)
Enumeration Date2007-06-14
Last Update Date2007-07-08
Business Address
-- STACY MARIE WAGNER D.O.
1200 PLEASANT ST
DES MOINES, IA 50309-1406
Phone number: 515-241-4497
Mailing Address
-- STACY MARIE WAGNER D.O.
1200 PLEASANT ST
DES MOINES, IA 50309-1406
Phone number: 515-241-4497