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1790050433
ANTHONY JOSEPH WAGNER
SALEM, OR
NPI
1790050433
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2012-03-13
Last Update Date
2012-03-13
Business Address
-- ANTHONY JOSEPH WAGNER
3878 BEVERLY AVE NE BUILDING H
SALEM, OR 97305-1394
Phone number: 503-576-4692
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Mailing Address
-- ANTHONY JOSEPH WAGNER
5285 SW NASH AVE
CORVALLIS, OR 97333-9312
Phone number: 503-459-7199
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