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
—
—
Other
Enumeration date
11/02/2013
Last updated
11/02/2013
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