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Marie Wagner
NPI 1184895070 · on the registry since 2008 · sole proprietor
Practice
- Address
- 365 Sw Log Dr
Port Saint Lucie, FL 34953 - Phone
- (772) 785-6473
- Fax
- (772) 408-0998
Registry record
- Primary taxonomy
- Contractor
171W00000X
- Licence states on file
- FL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2008-03-18
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida