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1740366350
MATTHEW WAGNER
SACRAMENTO, CA
NPI
1740366350
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
Additional Taxonomies
171M00000X Case Manager/Care Coordinator
Enumeration Date
2006-10-27
Last Update Date
2007-07-08
Business Address
-- MATTHEW WAGNER
4600 47TH AVE STE 111
SACRAMENTO, CA 95824-3923
Phone number: 916-393-1222
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Mailing Address
-- MATTHEW WAGNER
10741 FAIR OAKS BLVD APT 110
FAIR OAKS, CA 95628-7903
Phone number: 916-965-5190
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