JACK WAGONER

JACKSON, MI
NPI1598700072
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207L00000X Anesthesiology
(Licence: MI  4301-407025)
Enumeration Date2006-06-18
Last Update Date2007-11-06
Business Address
Dr. JACK WAGONER M.D.
205 N EAST AVE
JACKSON, MI 49201-1753
Phone number: 517-788-4963
Mailing Address
Dr. JACK WAGONER M.D.
205 N EAST AVE
JACKSON, MI 49201-1753
Phone number: 517-788-4963
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