ERIC WAGNER

SPARTA, WI
NPI1487043196
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: WI  309254-031)
Enumeration Date2015-01-19
Last Update Date2015-01-19
Business Address
-- ERIC WAGNER LPN
526 W MAIN ST
SPARTA, WI 54656-2146
Phone number: 608-387-3586
Mailing Address
-- ERIC WAGNER LPN
526 W MAIN ST
SPARTA, WI 54656-2146
Phone number: 608-387-3586
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