Individual
DR. TOM L WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
509 MAIN ST, DR TOM L WAGNER, MURRAY, KY 42071
(270) 759-1210
(270) 753-6210
Mailing address
BOX 2784 MSU, MURRAY, KY 42071
(270) 759-1210
(270) 753-6210
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
KY319
KY
Other
Enumeration date
07/25/2006
Last updated
07/08/2007
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