PAUL BROOKS WAGNER

MODESTO, CA
NPI1518063916
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy246XC2903X Spec/Tech, Cardiovascular, Vascular Specialist
(Licence: MS  890191-0970)
Enumeration Date2006-09-15
Last Update Date2007-07-08
Business Address
Mr. PAUL BROOKS WAGNER C.C.P.
1836 HARBOR CV
MODESTO, CA 95355-1856
Phone number: 209-484-8516
Mailing Address
Mr. PAUL BROOKS WAGNER C.C.P.
1836 HARBOR CV
MODESTO, CA 95355-1856
Phone number: 209-484-8516
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