Individual
SAMUEL DUANE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RRT
Contact information
Practice address
RR 1 BOX 281W, THORNTON, WV 26440-9721
(304) 265-3032
Mailing address
RR 1 BOX 281W, THORNTON, WV 26440-9721
(304) 265-3032
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
LRTR0128
WV
Other
Enumeration date
02/06/2008
Last updated
02/06/2008
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