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Organization
ST. MARY'S HEALTH WAGON
Active
Organization
ST. MARY'S HEALTH WAGON
Active
Other names
The Health Wagon
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERESA L. GARDNER D.N.P. (EXECUTIVE DIRECTOR)
(276) 328-8850
Entity
Organization
Contact information
Practice address
5626 PATRIOT DRIVE, WISE, VA 24293-7070
(276) 328-8850
(276) 328-8853
Mailing address
5626 PATRIOT DRIVE, WISE, VA 24293-7070
(276) 328-8850
(276) 328-8853
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/02/2013
Last updated
11/02/2013
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