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1952842346
JAMES EVERETT WAGNER
MEDFORD, OR
NPI
1952842346
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2017-03-17
Last Update Date
2018-02-26
Business Address
JAMES EVERETT WAGNER BS, QMHA
1175 E MAIN ST STE 1C
MEDFORD, OR 97504-7457
Phone number: 541-772-0127
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Mailing Address
JAMES EVERETT WAGNER BS, QMHA
715 SW RAMSEY AVE
GRANTS PASS, OR 97527-5500
Phone number: 541-474-5579
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