NPI 1487801635

Laura Wagner, INC

Organisation Specialist Saint Peters, MO

Practice location

Address: 6 Jungermann Cir Suite 211, Saint Peters, MO 63376-1621
Phone: (636) 926-7938
Fax: (636) 926-2286
Mailing address: PO Box 790379, Saint Louis, MO 63179-0379

Authorised official

Name: Laura Ella Wagner
Title: President
Phone: (636) 926-8554

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence R8N01 (MO)

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Registry record

NPI: 1487801635
Entity type: Organization
NPI issued: 19 Aug 2008
Record last updated: 19 Aug 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.