JERAD SCOTT WAGNER

ARDMORE, OK
NPI1932448347
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: OK  2197)
Enumeration Date2013-02-05
Last Update Date2016-01-27
Business Address
-- JERAD SCOTT WAGNER PA-C
921 14TH AVE NW
ARDMORE, OK 73401-1837
Phone number: 580-223-5311
Mailing Address
-- JERAD SCOTT WAGNER PA-C
921 14TH AVE NW
ARDMORE, OK 73401-1837
Phone number: 580-223-5311
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