CLAYTON THOMAS WAGNER

APPLE VALLEY, MN
NPI1902303589
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: MN  68745)
Enumeration Date2018-04-10
Last Update Date2021-07-13
Business Address
CLAYTON THOMAS WAGNER
15290 PENNOCK LN
APPLE VALLEY, MN 55124-7163
Phone number: 952-431-8500
Mailing Address
CLAYTON THOMAS WAGNER
8170 33RD AVE S MS 21110Q
BLOOMINGTON, MN 55425-4516
Phone number:
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