MITCHEL ALAN WAGNER

PEORIA, IL
NPI1609440684
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: IL  036166029)
Enumeration Date2021-05-14
Last Update Date2023-10-03
Business Address
MITCHEL ALAN WAGNER DO
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number: 309-655-2109
Mailing Address
MITCHEL ALAN WAGNER DO
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number: 309-655-2109
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