EBONY WAGNER

FLORISSANT, MO
NPI1417402397
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: MO  2013023536)
Enumeration Date2016-08-19
Last Update Date2016-08-19
Business Address
-- EBONY WAGNER
2325 PATTERSON RD
FLORISSANT, MO 63031-2205
Phone number: 314-620-5553
Mailing Address
-- EBONY WAGNER
2325 PATTERSON RD
FLORISSANT, MO 63031-2205
Phone number: 314-620-5553
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