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1538638309
MIRANDA WAGNER
DALLAS, TX
NPI
1538638309
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: DT85579)
Enumeration Date
2018-11-21
Last Update Date
2018-11-21
Business Address
MIRANDA WAGNER LDN
4100 SPRING VALLEY RD STE 515
DALLAS, TX 75244-3803
Phone number: 817-751-7802
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Mailing Address
MIRANDA WAGNER LDN
175 E HAWTHORN PKWY STE 235
VERNON HILLS, IL 60061-1454
Phone number: 847-737-8768
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