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1902303589
CLAYTON THOMAS WAGNER
APPLE VALLEY, MN
NPI
1902303589
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MN 68745)
Enumeration Date
2018-04-10
Last Update Date
2024-10-04
Business Address
CLAYTON THOMAS WAGNER
15350 ENGLISH AVE
APPLE VALLEY, MN 55124-6252
Phone number: 952-431-8500
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Mailing Address
CLAYTON THOMAS WAGNER
8170 33RD AVE S MS 21110Q
BLOOMINGTON, MN 55425-4516
Phone number:
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