Individual
MR. WILLIAM VANWAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
421 N MAIN ST, LEEDS, MA 01053-9764
(413) 582-3010
(413) 582-3185
Mailing address
421 N MAIN ST, LEEDS, MA 01053-9764
(413) 582-3010
(413) 582-3185
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1350
MA
Other
Enumeration date
07/10/2006
Last updated
07/10/2007
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