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Individual
MR. BRUCE ROBERT WAGNER
Active
Individual
MR. BRUCE ROBERT WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCC AUDIOLOGY
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2201000223
VA
237600000X
Audiologist-Hearing Aid Fitter
2101000261
VA
Other
Enumeration date
05/21/2008
Last updated
05/21/2008
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