Individual
MRS. PAIGE ANN WACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C. HT.
Contact information
Practice address
820 S MAIN ST, STILLWATER, OK 74074-4631
(405) 564-4766
(405) 533-4343
Mailing address
820 S MAIN ST, STILLWATER, OK 74074-4631
(405) 564-4766
(405) 533-4343
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
204-214
NM
Other
Enumeration date
02/12/2009
Last updated
02/12/2009
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