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1790304442
JACOB TIMOTHY WAGNER
LA CROSSE, WI
NPI
1790304442
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
213E00000X Podiatrist
(Licence: WI 1303)
Enumeration Date
2020-04-13
Last Update Date
2023-01-13
Business Address
JACOB TIMOTHY WAGNER DPM
1836 SOUTH AVE
LA CROSSE, WI 54601-5429
Phone number: 608-782-7300
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Mailing Address
JACOB TIMOTHY WAGNER DPM
1836 SOUTH AVE
LA CROSSE, WI 54601-5429
Phone number: 608-782-7300
Copy
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