Individual
SHARON DARLENE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
440 INGRAM DR, KING, NC 27021-8208
(336) 983-4900
Mailing address
PO BOX 167, PINE HALL, NC 27042-0167
(336) 750-7410
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
11693
NC
Other
Enumeration date
04/10/2019
Last updated
04/10/2019
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