Individual
JAN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDLD
Contact information
Practice address
4851 WUNNENBERG WAY, WEST CHESTER, OH 45069-4855
(513) 874-8800
Mailing address
1521 ST.CLAIR AVE, CINCINNATI, OH 45231
(513) 931-0452
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
4781
OH
Other
Enumeration date
07/14/2014
Last updated
07/14/2014
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