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1669432415
STEPHEN W WAGNER
SPRINGFIELD, IL
NPI
1669432415
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: IL 209000775)
Enumeration Date
2006-03-24
Last Update Date
2007-07-08
Business Address
-- STEPHEN W WAGNER CRNA
701 N IST ST
SPRINGFIELD, IL 62781-0001
Phone number: 217-788-3754
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Mailing Address
-- STEPHEN W WAGNER CRNA
701 N IST ST
SPRINGFIELD, IL 62781-0001
Phone number: 217-788-3754
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